QA & Medicare Compliance, Education Program Post
Acquisition, Alliance Medical Solutions, Kentucky (US)
Client Issue: Our client was a newly formed Durable Medical Equipment (DME) Provider after acquiring assets of company which had undergone a federal government investigation (OIG & HHS) for Medicare/Medicaid Fraud.
The client requested assistance in identifying key elements for obtaining & procuring new Medicare Provider number, new durable medical equipment licenses to operate in multiple states & new third party payor contracts in order to obtain reimbursement for services as a Durable Medical Equipment Provider.
Solution: Compliance education for new owners & executives regarding Medicare & related compliance training. New company-wide policies & procedures, organisational charts, branding strategies, key core processes identified with staff training, patient education materials, & sales/marketing training were conducted. Transitioning from previous company to the newly formed organisation, included procurement of new state DME licensure applications, third-party payor contracts for reimbursement & Medicare provider number application support. Training of staff to prepare for on-site CMS survey & positioning company to pursue accreditation for competitive bidding market participation.
Outcome: Successful implementation & processing of third party payor contracts, multi-state licensure for status as DME provider, successful visit for Medicare Provider site survey & obtained Medicare provider number, implementation of compliance training, patient education materials, sales & marketing training, policies & procedures.