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HME Audit Key: Analysis Shows Promising Data; 2nd Quarter Submission Round Now Open

Posted on in Billing/Reimbursement

By AAHomecare

Results are in from the most recent HME Audit Key survey. The latest round of results, including ADRs from October 1, 2015, through March 31, 2016, show the following:

  • Preliminary data on MAC prepayment audits shows interestingly high approval rates. Based on the current group of participating suppliers, 69 percent of completed MAC prepayment audits nationwide were paid upon review
  • Based on the products surveyed, the average rate of audits denied increased 5 percent between Quarter 4 of 2015 and Quarter 1 of 2016 among participating suppliers. The average percent of audits denied by net revenue ranged from 13-40 percent.
  • Preliminary data also shows that participating companies with net revenue from $3.6-10 million had significantly higher denial rates; three times that of the $0-1 million participating suppliers.

Click here to read the full report on the latest findings, and click here for additional information.

Survey gaining momentum

With two quarters of data now collected, the survey is gaining momentum. However, we need all suppliers to participate, regardless of the number of audits you are receiving. With increased confidence levels in the data, AAHomecare will be able to tell a compelling story about the audit and appeal experience on our industry.

The next round of data submission is now open through July 29. Click here to join the program and submit your 2nd quarter 2016 audit data TODAY. You will need one of your organization's NPIs and respective five-digit zip code.

What kind of information is required and how does my company benefit by participating?

The Audit Key does not require you to submit data on individual claims but instead seeks cumulative counts of pre- and post-payment audits and appeal outcomes under DME MAC, RAC and SMRC reviews.

In addition to providing critical data for the campaign for audit reform, individual suppliers will have access to their own quarterly survey results and will have access to aggregate survey results and key findings. Suppliers can use this information to see how they compare to others in terms of audit volumes and appeal overturn rates.

The HME Audit Key is sponsored by the American Association for Homecare. Learn more at HMEAuditKey.org.

 

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