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October 15, 2024
2:30PM - 3:30PM

Billing Non-Assigned: Steps to Replace Lost Income

Sponsored by AAHomecare

Webinar

Presented by: Jeff Baird, Esq. of Brown & Fortunato and Noel Neil with ACU-Serve

Member - No charge (member benefit)

Non-Member - $129 

Webinar description:

DME suppliers, like other health care providers, are being squeezed by traditional Medicare and Medicare Advantage (“MA”). In the traditional Medicare space, an example of this is the loss by DME suppliers of the 75/25 blended rates. To offset, at least in part, the decrease in reimbursement from traditional Medicare, DME suppliers should look seriously at billing traditional Medicare beneficiaries on a non-assigned basis. The movement to billing non-assigned is aided by the willingness of aging Baby Boomers to pay cash for “Cadillac” products, as opposed to being relegated to accepting “Cavalier” products when the DME supplier takes Medicare assignment.

Billing non-assigned means that the Medicare beneficiary pays cash up front to the DME supplier and is directly reimbursed by Medicare. This program will discuss the multiple issues arising out of billing on a non-assigned basis, including the following:

• What does it mean to bill non-assigned?
• If the supplier bills an item non-assigned, can the supplier set the price without limitation?
• Must the supplier submit a claim to Medicare so that the beneficiary can be reimbursed?
• Can the supplier sell a capped rental item for cash?
• Does the supplier need to obtain documentation supporting medical necessity?

Is the supplier at risk of having to repay Medicare and/or the beneficiary in the event of a subsequent audit?

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