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The Consulting Program is designed to help suppliers deal with the constantly changing world of Medicare reimbursement. With Medicare rapidly increasing the number of on-site and written audits it conducts, the Consulting Program can reduce the possibility of errors in your company's Medicare documentation procedures and help you stay in compliance of all regulations.

Services
  Mock Medicare Audits  A random sampling of patient charts to identify possible problem areas with Medicare documentation and claim submissions.

Operational Analysis  A review of your company's order process from the time the order is received through the receipt of payment from Medicare.

Reimbursement Training  Customized training sessions tailored to your needs.

Fee-For-Service  A one-time pre-screen performed for an hourly rate. Other consulting services can be performed on a fee-for-service basis after an initial review is completed.

Stricter enforcement of Medicare policy and the constant changes in regulation have resulted in an increasing amount of claim denials. The Pre-Screen Program relieves suppliers of the burden of keeping on top of all the changes in medical policy and claim submissions.

Services
 

Documentation Review  The Orion Group will organize any documents required by Medicare for the coverage of durable medical equipment (except lymphedema pumps), urological, parenteral, and enteral claims. The supplier will be given the necessary eligibility forms to ensure that all the information is received.

Certificate of Medical Necessity Review  If a CMN is required, The Orion Group will provide written advice on how the CMN will need to be completed.

Guaranteed Turn Around Time Once all the necessary documentation is provided to The Orion Group staff, the supplier will receive the reviewed documents back within five business days. Any information received after 2:00pm EST will be counted as the following day.

Money Back Guarantee  If The Orion Group accepts a claim for pre-screening, that specific claim will be guaranteed for payment. If the claim is denied after all avenues have been pursued, The Orion Group will refund the monthly service fee plus the pre-screening fee for that claim.


To help referral sources understand the importance of submitting claims correctly, The Orion Group is offering a Referral Source Program that allows suppliers to set up Medicare training sessions for their referral sources. These sessions help educate the supplier's referral sources on the do's and don'ts of Medicare reimbursement. The seminars are accredited, so in addition to learning valuable information, attendees will also earn CEUs.

Services
  Medicare 101 The Referral program is designed to teach therapists the basics of the Medicare system. Referral sources will leave with a greater knowledge of what is required to properly bill rehab products to Medicare, which includes understanding what Medicare review staff require in letters of medical necessity. Receiving proper documentation the first time reduces the amount of time suppliers and therapists spend on paperwork and assures that the client will receive appropriate product and correct coverage.

Accredited Program  Referral sources earn valuable CEUs for attending.

Customized Sessions  The Orion Group will tailor the seminar to the supplier's needs. Whether it's a half day or full day session, we'll focus in on what will help your business the most.


Medicare's 6-month limit on appealing claims has left many suppliers scrambling to deal with denied or downcoded claims. The Recovery Program helps suppliers collect money that might be lost without proper follow up on claims denied or downcoded for lack of medical necessity.

Services
  Claim Review  The Orion Group staff will determine whether the claim should be submitted as a resubmission, an informal review or as a hearing request. All medical justification needed would be provided based on the information received from the supplier.

Documentation Review for Downcoded or Denied Claims  The Orion Group will organize any recovery documents required by Medicare for the coverage of durable medical equipment (except lymphedema pumps), urological, parenteral, and enteral claims. Additional documentation will be requested if needed.

Guaranteed Turn Around Time  Once all the necessary documentation is provided to The Orion Group staff, the supplier will receive the recovery documents back within five business days. Any information received after 2:00pm EST will be counted as the following day.


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