What You Need to Know About HME Audit Key: An Update

WASHINGTON, D.C. (December 23, 2015)—The initial HME Audit Key test survey from earlier this year tracked audits received from October 2014 through June 2015. One of the preliminary findings was suppliers appealed 80 percent of MAC prepayment denials for respiratory products, and 92 percent were overturned. While based on a small test pool of participants, other findings from the survey indicate that:

• 55% of ostomy, urological and wound care supply new patients are subject to MAC prepayment audit
• Data analysis shows similarities between large national and small suppliers, dispelling the myth that large or small suppliers experience more or less audits
• Over 86 percent of MAC prepayment audits of power mobility devices were paid upon review

The presentation showing these figures and more is available here.

These preliminary findings are intriguing, but we need to see what the data from a larger cohort will tell us about how HME suppliers are responding to RAC, MAC and SMRC audits nationwide. Please register here to participate in the HME Audit Key; you can also find videos giving a program overview and demonstrating how to enter your audit data here.

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. Your company’s individual results will never be available to other entities, but will be included in aggregate data.

Support/assistance in registering or entering your information in the Audit Key is available by contact form, by emailing [email protected], or by calling 1-844-HME A KEY (844-463-2539). For questions about how your participation will help audit reform efforts and benefit your company, email [email protected].

Visit aahomecare.org for more information.