As a part of our valued relationship with our clients, we want to make sure you are aware of the information below in order to spare your practice from unnecessary burden caused by Durable Medical Equipment (DME) suppliers requesting documentation from you.

In the last few weeks the Greater Kansas City Medical Managers Association (GKCMMA) released the following news from their Payor Relations Committee:

CMS audits are familiar to most of us. Recently their audit activity has increased significantly for DME suppliers which in turn is having an effect on the physician community. This effort is aimed at reducing fraud and abuse. A number of practices in Kansas report being inundated with phone calls and faxes from DME suppliers requesting documentation.

The DME suppliers have 45 days to respond to CMS’ requests.  As that deadline approaches, the DME suppliers are turning to practices to supply documentation that supports the DME items provided to patients. It is one national supplier’s policy to make calls to the ordering physician every 3 days until the provider responds to their request for documentation. In addition to the request for records the suppliers are sometimes requesting the provider enter an addendum to their medical record.

The question on everyone’s mind…Do I have to provide the documentation or make an addendum to the record?

The answer is NO, and CMS agrees. The onus is on the DME supplier to have the supporting documentation and they should have it prior to providing the service (equipment) . There are, however, documentation requirements for DME supplies and Noridian has some good information. For more information click here.

As a reminder, ScanSTAT’s standard service level agreement excludes providing records for DME and other referral type records requests that are stat or do not require a signed HIPAA authorization. If you would like for us to release these records for you, give us a call. We are happy to quote that service for you.

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