News and Updates

Check Your Medicare Product Categories Now to Prevent Denials

(June 10, 2010)

The Centers for Medicare & Medicaid Services (CMS) has announced that beginning July 6, 2010 that claims submitted to the Durable Medical Equipment Medicare Administrative Contractors will be automatically denied if a supplier is not accredited to supply a specific product/service AND it is not exempt from accreditation.

Of most importance to home infusion therapy providers is that such denials would apply to claims for enteral nutrients, equipment and supplies.

Take a Proactive Step: If you are providing enteral nutrition therapies to Medicare patients, avoid surprises by comparing the product categories on file with your accreditor to those on file with the National Supplier Clearinghouse (NSC). If there are discrepancies, contact the accreditor and/or the NSC to resolve them prior to July 6.

Even if you do not provide enteral nutrition therapies, it would be a good idea to do this product category check in order to prevent future denials that might arise from such discrepancies for other products/services that you bill to Medicare.