"Van Halem: It all comes down to communication and education with the referral sources. Unfortunately, CMS puts that burden onto the supplier and most physicians don’t know the documentation requirements. There should be some sort of internal QA or prior approval process. These days, it is not enough to just request documentation — you should also review it and determine whether the patient qualifies. Many suppliers are now being forced to turn away patients and transfer liability to them because they can’t get the documentation that they need to substantiate reimbursement."
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