O&P Insight

There is a common misconception that miscellaneous (‘99) codes are not paid by many payers. In our experience, miscellaneous code denials are typically the result of the code being incorrectly billed. All miscellaneous codes require a very specific claim narrative, depending on what item is being billed. Many payers offer specific guidance on what should be included in this claim narrative. When in doubt, it should include at least a narrative description of the item and the supplier retail price for the item. Need help? We are here for you! #oandp #codingwithcurt #miscellaneouscodes #spookyideas #detailsondetails

On Wednesday, November 6th at 9:00am PST, our industry partner PROTEOR USA will be hosting a free webinar on Navigating the K2 MPK LCD Updates, which will include coverage requirements and best practice documentation guidelines. Our Compliance Analyst, Michelle Wullstein, CPCO, will be presenting in-depth details on the LCD and Policy Article Updates and how they will impact your practice. Don't miss out, register today! #oandp #freewebinar #registertoday #getthedeets #proversityeducation #LLPLCDupdates #industrypartners Registration Link: https://lnkd.in/gXEmutkU

Just for fun...did you know the O&P Insight Team is completely remote and spread across 13 different states? We feel fortunate that a strong remote environment gives us the ability to attract and retain such awesome talent across the US. From coast-to-coast we have you covered! Can you guess some of the states? #oandp #funfactfriday #talentinallareasoftheUS #goteamoandpinsight #remoteteams #connectedworld

Diagnosis codes could have a greater impact on claims processing than you may think. Even if a particular policy does not have diagnosis code criteria, this doesn't necessarily mean any diagnosis code can be billed on the claim. The primary diagnosis code should be directly related to the symptoms or conditions being treated by the device. If applicable, the secondary diagnosis should correlate with the underlying condition causing the symptoms. #oandp #reimbursementroadmap #diagnosiscodes #claimsprocessing #wewantyoutothrive #letusknowhowwecanhelp Connect with us for more details!

With the recent addition of new custom fitted orthoses to Medicare’s Prior Authorization program, it can be easy to fall into a false sense of security when you receive an “Affirmed” authorization. Remember, if you are going to code the item as custom fitted, the quality and detail of delivery documentation is critical to ensure the claim does not get recouped in a post payment review. #oandp #compliancecheckin #medicarepriorauth #customfittedfun #orthosespriorauthupdate #documentation Have a question about custom fitted coding and documentation? We can help - connect with us at 725-238-2008.

Our Vice President and General Manager, Lesleigh Sisson, CFo, CFm has been invited as a Keynote Speaker at the upcoming 2024 California Orthotic and Prosthetic Association Annual Symposium, November 7th-8th at Loma Linda University. If you are attending, she will be presenting Exploring the Strategic Integration: O&P Insight’s Acquisition by Hanger Inc. on Friday, November 8th. As an advocate for independent O&P businesses, she will be reinforcing the strategic vision of O&P Insight and how we will be able to support more practices with additional resources. We hope to see you there! #oandp #keynotespeaker #leader #copa2024 #weloveoandp #jetsettingagain #networkwithus #wewantoandpbusinessestothrive More Information: https://lnkd.in/gTMZ69Ek

Free webinar announcement! A common issue we see with our clients is the proper use and completion of the Advance Beneficiary Notice of Noncoverage (ABN). Join us next week to discuss requirements for the ABN form under the traditional fee-for-service Medicare program. This includes instructions for properly completing the ABN form and tips for preventing common mistakes. We will differentiate between situations when the ABN would be required versus when it is optional and review some common scenarios when an ABN would appropriate for O&P items. #oandp #freewebinar #registertoday #oandpspecialists #letushelpeliminatewhatsholdingyouback #helpingoandpbusinessesthrive Register Here: https://lnkd.in/gk6FDd4c

The 2024 LEAD the Way Annual Conference was one for the books! We hosted a wonderful group of clients, new attendees, returning and inaugural sponsors, and amazing guest speakers! We are so grateful to everyone who supported our event and brought such great positivity and enthusiasm. The success of LEAD the Way; Leveraging Your Leadership makes us even more excited for next year's conference! #oandp #LeadtheWay #LEADtheWay2024 #leadershipconference #businessconference #weloveoandp Stay tuned for more posts from this years conference and for information about our 2025 LEAD the Way Annual Conference; The Many FACETS of Business - October 9-10th, at the Durango Casino & Resort in Las Vegas, Nevada.

Big shout out to Kristen Tosi

CMS recently issued a 1135 waiver related to Hurricane Helene for the following States: South Carolina, Tennessee, North Carolina, Georgia, Florida, and Louisiana This means that if any beneficiary needs a replacement DMEPOS item as a result of displacement or damage due to the hurricane, the replacement will be covered and items must be billed with both the RA modifier and the CR modifier (in addition to all other policy-specific modifiers). We also recommend a claim narrative (“Replacement due to Hurricane Helene”). The patient does not need to seek out a provider/supplier in their area for this replacement and does not need to be located in one of the above mentioned states to provide the replacement item and appropriately bill the CR modifier. #oandp #reimbursementroadmap #timelyreimbursementinfo #modifiers #replacementDMEPOS #hurricanehelene