EBG Advisors and Epstein Becker Green (EBG) provided Medicare billing compliance and accreditation assistance to a medical device manufacturer and supplier introducing new devices and supplies to market.

The EBG Advisors/EBG Team worked with the client, a newly Medicare-enrolled durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) supplier, to adopt specific supplier policies, procedures, and processes needed to comply with Medicare supplier standards.  Additionally, the EBG Advisors/EBG Team performed a compliance review and provided counseling regarding Medicare accreditation and reaccreditation preparation by recommending elements for a quality improvement plan.

With respect to Medicare and other third-party payer coding, coverage and payment considerations, the EBG Advisors/EBG Team reviewed and recommended revisions to the client’s Medicare and Veterans Affairs coverage policies for its new products. and helped the client develop processes for collecting appropriate documentation needed to establish medical necessity for its new products.  The EBG Advisors/EBG Team conducted prepayment medical review of all of the client’s Medicare claims and assisted staff with Medicare claims processing for newly established Healthcare Common Procedure Coding System (HCPCS) codes. The EBG Advisors/EBG Team also assisted the client in formalizing the client’s own internal process for conducting primary and secondary medical review prior to claims submission.

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