Department of Veterans Affairs Audit Notice

The Department of Veterans Affairs has a contract with Health Net Federal Services to conduct a review of claim payments to Non-Veterans Affairs providers. They will be reviewing the appropriateness and accuracy of VA payment of outpatient claims between October 1, 2009 and September 30, 2011.  

Providers who receive a letter from Health Net Federal Services requesting medical documentation should comply with this request promptly.  

WPS Medicare Part B eNews Question

From WPS Medicare Part B Legacy eNews for Monday, February 21, 2011:

WHAT IS THE CORRECT DATE OF SERVICE?

Question: My patient had a chest x-ray on Tuesday. I read the chest x-ray on Wednesday. I performed both services in my office. What date of service (DOS) do I use for the professional component (reading) of the chest x-ray? Does the answer change if I have performed both components or if a hospital or other entity performed the technical (the taking) component?   

Answer:  The Centers for Medicare & Medicaid Services (CMS) Internet-Only Manual (IOM) Publication 100-02, Chapter 15, Section 20 discusses when expenses are incurred. "Part B expenses for items are considered to have been incurred on the date the beneficiary received the item or service, regardless of when it was paid for or ordered." This instruction does not change based on who performed which components. The appropriate DOS for the professional component is the date the physician performed the interpretation.    

Note: This mainly pertains to providers who are reading an x-ray or test and do not own the machine utilized for testing.