APMA News - March/April 2019 - 39

Reimbursement
minations submitted using the provider portal will take 30
days to process, although the DME MAC has up to 90 days to
process the appeal after its receipt.
Finally, if providers encounter a possible "same or similar"
scenario upon using the provider portal, they should consider obtaining a properly executed advanced beneficiary notice
Suppliers may still initially reUsing
the
provider
portal
avoids
(ABN). A properly executed ABN
ceive a "same or similar" rejection.
should be specific as to why the
fax transmission errors and
However, a properly documented
new device may not be covered.
progress note including the above
provides
instant
assurance
that
Information to include in the
information may be used to sucABN should include the name of
the information submitted has
cessfully appeal (redetermination)
the device dispensed, date of sera rejection. The redetermination
been
received
by
the
DME
MAC.
vice, name of supplier, and that
form is available on the DME MAC
any new device may result in a
websites and/or provider portals.
"same
or
similar"
rejection.
Once this form is downloaded and completed, providers may
APMA is in communication with the DME MAC medical
scan the form (or complete and save it online) and then updirectors
to try to address this issue. Until the matter has been
load the form and other pertinent information, including the
resolved,
following the guidance outlined here is recommendresponse letter and their chart documentation, directly onto
ed.
This
situation
is fluid, and APMA urges members to monthe DME MAC provider portal.
itor
APMA.org
for
future developments.
■
Using the provider portal avoids fax transmission errors
and provides instant assurance that the information submitted has been received by the DME MAC. Providers may also
For further advice, contact the Health Policy and
follow the appeals process via the provider portal and read
Practice department at healthpolicy.hpp@apma.org.
any comments made by the nurse reviewer. Typically, redeter-

*

loss or gain) resulting in the previous device being unusable by the patient; or
different physiologic need (e.g., previous device was
for a non-weight-bearing situation and the new device
is for a weight-bearing situation).

ACCESS TOP INDUSTRY
SUPPLIERS AT THE INTERSECTION
OF PODIATRY & TECHNOLOGY
Find the answers
to all your products
and services needs
on the newly
designed APMA
Buyers' Guide.

apma.officialbuyersguide.net

For more information, please contact:
SaraCatherine Goodwin, Senior Project Manager
Naylor Association Solutions
(770) 810-6977 | sgoodwin@naylor.com

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2019-02-21 10:02 AM

APMA News March/April 2019

39


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APMA News - March/April 2019

Table of Contents for the Digital Edition of APMA News - March/April 2019

Contents
APMA News - March/April 2019 - Cover1
APMA News - March/April 2019 - Cover2
APMA News - March/April 2019 - 3
APMA News - March/April 2019 - 4
APMA News - March/April 2019 - 5
APMA News - March/April 2019 - 6
APMA News - March/April 2019 - 7
APMA News - March/April 2019 - Contents
APMA News - March/April 2019 - 9
APMA News - March/April 2019 - 10
APMA News - March/April 2019 - 11
APMA News - March/April 2019 - 12
APMA News - March/April 2019 - 13
APMA News - March/April 2019 - 14
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APMA News - March/April 2019 - 16
APMA News - March/April 2019 - 17
APMA News - March/April 2019 - 18
APMA News - March/April 2019 - 19
APMA News - March/April 2019 - 20
APMA News - March/April 2019 - 21
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APMA News - March/April 2019 - 25
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APMA News - March/April 2019 - 30
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APMA News - March/April 2019 - 34
APMA News - March/April 2019 - 35
APMA News - March/April 2019 - 36
APMA News - March/April 2019 - 37
APMA News - March/April 2019 - 38
APMA News - March/April 2019 - 39
APMA News - March/April 2019 - 40
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APMA News - March/April 2019 - 85
APMA News - March/April 2019 - 86
APMA News - March/April 2019 - Cover3
APMA News - March/April 2019 - Cover4
APMA News - March/April 2019 - A1
APMA News - March/April 2019 - A2
APMA News - March/April 2019 - A3
APMA News - March/April 2019 - A4
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