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Palmetto Results for Provider Specific Probe: July Through September 2022

Palmetto Results for Provider Specific Probe: July Through September 2022

by Caroline Fife, M.D. | Nov 27, 2023 | Featured, Medicare Audits

I am posting a series of articles with information directly from the websites of the various MACs. Anyone can access this information so I feel a little silly posting it, but several clinicians have told me about audits they are undergoing and they had not paid...
Can Someone Explain the Math on the Patient Copay for CTPs (Skin Substitutes)?

Can Someone Explain the Math on the Patient Copay for CTPs (Skin Substitutes)?

by Caroline Fife, M.D. | Oct 5, 2023 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Featured

Check out the entire series here. Let’s talk about the column that is NOT discussed in this table (from a manufacturer’s advertisement previously posted), and that is the patient responsible portion. I added a column to represent the patient co-pay if the patient does...
If You Wonder Why CMS is Looking at Skin Subs, Check Out These Claims…

If You Wonder Why CMS is Looking at Skin Subs, Check Out These Claims…

by Caroline Fife, M.D. | Oct 3, 2023 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Featured

Check out the entire series here. Here is another example. Feel free to keep sending me examples and I will redact the names of the company and post. Can anyone tell me why no invoice is needed to submit these claims and exactly how these profits are being realized?...
Wound Care Reimbursements

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