MiraVista, LLC

Learning how medical billing works is difficult. It takes a lot of concentration, practice, and patience from experienced peers. Maintaining billing expertise is something else altogether. Working DME professionals have to adapt their understanding and habits … all while getting the job done at full speed. When insurance rules change, it is like trying to change a tire without stopping the car. To do just that - metaphorically speaking, of course - join us for (K)notes today, October 24, 2024, at 1:00 PM (ET). In this episode, Andrea covers: - CMS considerations for a separate ventilator NCD for COPD patients. - What DME suppliers should – and should not – read into LCD changes about the role of prescriptions in medical records. - Finalized coverage for multi-function airway clearance devices. - The end of IVR support for eligibility inquiries. There’s more, but you get the idea. See you there … we’ll bring the driving gloves and tire irons!

Movies have a way of making it seem like the innocent and well intentioned always escape bad situations unscathed. Near misses are usually entertaining, sometimes even amusing in the movies. Medicare isn’t the movies. Fortunately, DME suppliers can escape Medicare’s speeding blue van - whether it be PTAN deactivation, unfavorable audits, or any myriad of daily threats – by simply looking both ways before crossing … metaphorically speaking, of course. To do so, start by joining us for (K)notes tomorrow, August 22, 2024, at 1:00 PM (ET). In this episode, Andrea covers: - How DME suppliers can avoid the recent uptick in PTAN deactivations. - What suppliers should do when their patients receive a breach notice from Change Healthcare. - New FAQs about coverage for lymphedema treatment. - Documenting test evaluation to audit-proof oxygen claims. Register for (K)notes here: https://lnkd.in/e7KQBjne

As we celebrate our country’s independence this week, we also celebrate independent DME suppliers. By independent, I mean those of you that take responsibility for that last mile of patient care even when it includes unprofitable routes, unreasonable workloads, and of course, unbearably complex reimbursement rules and obstacles. Happy Independence – and Independent’s – Day! The MiraVista Team

I bet you spend a lot of time thinking about how to explain the complexities of insurance to your customers and referring physicians … and probably to your friends and parents and parents’ friends for that matter. I know I do. That’s why I like a podcast called an “An Arm and a Leg.” The series is self-described as “a show about why healthcare costs so freaking much, and what we can (maybe) do about it.” Its audience is healthcare users, not practitioners, and I think understanding that perspective is incredibly helpful to those of us behind the curtain in the Land of Oz we call reimbursement. Read more on the MiraVista Blog: https://lnkd.in/gYyAWAYr

For the last four months or so, we know you have had your hands full restoring electronic claim transmissions and payment authorizations. The Change Healthcare cyberattack didn’t just disrupt cash flow. It created a lot of extra work. At least Change is responsible for all the HIPAA-required breach notifications, right? Not exactly. The DME supplier is, after all, the covered entity. “We didn’t get hacked!” you might say. But here’s the thing. Almost every patient transaction includes written supplier promises to notify patients if the protected information they give you gets compromised. To satisfy your HIPAA responsibilities without stress overload, join us Thursday, June 20, 2024, at 1:00 PM (ET) for the next episode of (K)notes. In addition to helping DME suppliers navigate the evolving Change Healthcare hack, we are covering: - More efficient Medicare payment offset research. - DME MACs’ evolving stance on home assessments for manual wheelchairs. - New requirements for face-to-face visits, written orders prior to delivery, and prior authorizations for multiple product categories. Register for this event: https://lnkd.in/e7KQBjne

Ever wonder if other HME suppliers get hung up on the same denials you do? According to denial data for hundreds of suppliers across the country, it turns out … they do! But it doesn’t have to be that way … Andrea Stark and Prochant’s Joey Graham combed through national denial data and discovered the top 5 denials HME companies struggle with most. They are getting together tomorrow, May 30, 2024, at 12:00 PM (ET) to chat about the strategies they use to beat these common denials. Their practical approaches are like a cheat sheet for the big test. You can listen in for free by registering at https://lnkd.in/eGEhDGz7

If you haven’t been keeping up with the dialogue between CMS and Medicare Advantage Plans (MAPs), let me catch you up. CMS: For the last time, you cannot deviate from Medicare policy. MAPs: "Don't tell me what I can't do" Luckily, the next episode of (K)notes is all about what DME suppliers can do in these crazy times. You can use CMS’s most recent memo and FAQs to support appeals against MAPs that don’t follow applicable Medicare policy. You can maintain sensible payment posting and reporting amid ERN gaps caused by the Change Healthcare outage. You can stay ahead of the industry and reimbursement developments that impact your bottom line. Start by joining us for (K)notes tomorrow, April 18, 2024, at 1:00 PM (ET). (K)notes Registration Page: https://lnkd.in/eAYxgyBK

2024 Look Ahead for DME Suppliers is starting in 2 hours! If you haven't already, there is still time to register! Topics on deck today: - Medicare Advantage Plan Accountability. - Evolving Role of Prior Authorizations With Medicare, MAPs, and Medicaid MCOs. - Benefits and Challenges Associated With Offshore Subcontractors. Register at: https://lnkd.in/ebvEkGpB

DME billing has traditionally been a defensive sport. You know what I mean. Constantly looking over your shoulder. Flinching every time you get correspondence from a payer. It doesn’t have to be that way. You can look ahead to getting control of your Medicare Advantage payer relationships. Look ahead to finding the right reimbursement staff. Look ahead to a prior authorization strategy that makes sense. It's not too late to join Jeffrey Baird (Brown & Fortunato), Andrea Stark (MiraVista, LLC), and HME News Editor Elizabeth Beaulieu for the 2024 Look Ahead for DME Suppliers TOMORROW, February 8, 2024, at 1:00 PM (ET). And if you don’t want to look ahead, you can just show up to get straight answers in the Q&A that follows. See you there! To register: https://lnkd.in/ebvEkGpB

If your Medicare patient recently changed to a Medicare Advantage Plan, the new carrier may ask you how many rental payments Medicare paid before the switch so they can deduct those from what they owe. Yeah, no … they can’t do that. It violates Medicare policy. HINT: Chapter 4 of Medicare Managed Care Manual. Sections 10.2, 90.5, and 110.1.1 will give you the foundation you need to push back against shorted payments and other disallowed practices. And don’t worry. You are not alone if you never heard of the Medicare Managed Care Manual. Most suppliers haven’t … and too many carriers take advantage of that. Regaining control over your payer relationships is just one of the topics Andrea Stark, Jeffrey Baird, and Elizabeth Beaulieu cover at the 2024 Look Ahead for DME Suppliers on February 8, 2024, at 1:00 PM (ET). Register at https://lnkd.in/ebvEkGpB.