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David McGill Blogger

The Path to a Successful Claim

Posted by David McGill | May 08, 2014

As the MACs continue to publish prepayment claim review results we see claim denial rates continuing to hover between 70 and 90% around the country. The data suggest that more often than not, these denials rest on published Medicare guidance/policies, not on any secret code that the O&P community has failed to crack. With claim denial rates that high, how can you improve your chances of surviving a prepayment claim review or government audit?

Ossur's strategic partner, The Audit Team, offers a Quality Assurance Review program for your practice so that you know you have the required documentation to support your claims before you file them. For only $175/claim, The Audit Team provides you a training session to ensure that you understand coverage standards, personally analyzes your documentation, and organizes it into a professional "exhibit packet" that you can easily integrate into both the claim and any necessary appeals or audit responses.

The Audit Team is not an Ossur company. So unlike direct manufacturer reimbursement support offerings, you don't have to worry that it will ever give a claim the "thumbs up" in order to improve its bottom line. Rather, The Audit Team provides objective, comprehensive, and most importantly, independent reviews of suppliers' claim materials. Built on exceptional results and a collaborative, trusting relationship with its clients, The Audit Team  has performed more than 20,000 Quality Assurance Reviews for DMEPOS suppliers over the last 12 months. 

For more information about The Audit Team, please email Stephanie Morgan Greene, Esq. at  [email protected].

Össur R&R

The Source for O&P Reimbursement & Regulatory News & Analysis

If you have any questions for Össur’s Reimbursement Team or about Össur’s Reimbursement Services, please contact us at [email protected]