Össur announced that it has entered into an exclusive agreement with Harrington Management Group (HMG), a third-party consulting firm that specializes in O&P and durable medical equipment payment issues, to help prosthetists manage reimbursement issues related CMS directives, according to a news release.
As part of the agreement, HMG established The Audit Team, which will perform evaluations of pending Medicare filings for Össur Bionic prostheses.
Prosthetists can purchase specific services from HMG on an a la carte basis according to their needs, or they can purchase a package plan, which will include a quality assurance review of reimbursement documentation and support for appeals, if necessary. Once a claim has been certified as Medicare-ready, the Audit Team will warranty the claim by providing direct support to the practice throughout the appeals process, up to and including the Administrative Law Judge (ALJ) level. If the ALJ ultimately denies a medical necessity claim for an Össur Bionic prosthesis, The Audit Team will reimburse the practice for 90% of its fees.
“For the first time, prosthetists can choose to have an objective advocate in their corner, helping them navigate CMS’ complex rules and regulations, including challenging RAC audits,” Linda Collins, director of market access, legal and reimbursement for Össur Americas, stated in the release.