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Are You Submitting Your DME Claims to the Right Region?

Are You Submitting Your DME Claims to the Right Region?

The Centers for Medicare and Medicaid Services are making improvements in their durable medical equipment handling of medical billing departments. Very soon, they plan on implementing new Durable Medical Equipment Regional Carrier (DMERC) responsibilities. The durable medical equipment changes are designed to improve costs, quality of care, and medical billing efficiency.

The medical billing regions A and D will replace their DMERCs with Durable Medical Equipment Medicare Affiliated Contractors (DME MACs). This department will handle all the medical billing, and day to day operations such as customer service. A second program, called Program Safeguard Contractors (PSCs) will have the responsibilities of handling any medical billing fraud cases and reviews for medical necessity. Another huge change for this Durable Medical Equipment organization will be a Region A switch from the company HealthNow New York Inc, to the National Heritage Insurance Company. Noridian Administrative Services will take over Region D suppliers from CIGNA Government Services. Finally, the B and C Regions will have brand new contracts for their areas. Since the carriers will change, so will the medical billing procedures to meet some carriers requirements for reimbursement.

If you were used to your old medical billing region, listen up! Several states’ regions will change as the new MAC becomes effective. Maryland, Kentucky, Virginia, West Virginia, and the District of Columbia can all expect medical billing region changes in the near future. Although the way in which you submit your medical billing may not change, the location of submission may. Make sure you review the medical billing changes for DMERC before you submit your claims.

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