Providers see lull in mobility audits

Friday, February 21, 2014

With power mobility’s consistently high error rates, providers have long been targets for audits. However, some providers say things have been relatively calm lately. 

“The audits seem to have slowed,” said Tim Goodlett, director of operations at Omaha, Neb.-based Total Respiratory and Rehab. “I’m not sure if it’s because we’ve passed the majority of our claims.”

Audits tend to come in waves, providers say. Mary Shutes, director of reimbursement at Rochester, N.Y.-based Monroe Wheelchair, says the last one there was in May. 

“We actually got something from NHIC (the Jurisdiction A DME MAC) giving us six months off prepayment audits because our paperwork was so good,” she said. “Of course, we get audited from all directions, but it’s been relatively quiet overall.”

Even without a slew of additional documentation requests in their mailboxes, providers say audits are still causing grief, since they’re often still dealing with old audits.

“We’re still fighting audits that have been in process since before July 1,” said Mark Farmer, president of Mesa, Ariz.-based Southwest Mobility. “We tend to push as far as we can, and that usually means the ALJ. It helps to have a beating heart listen to us.”

Provider Scott Soderquist agreed, but he says that taking claims to the third level of appeals takes a lot of time, money and effort.

“It doesn’t help that Medicare is having a 30-month backlog on appeals,” said Soderquist, president of Manchester, N.H.-based Rehab Equipment Associates.