CourseAvenue, Inc. - Medical Necessity Certification

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Course Title: Medical Necessity Certification - Durable Medical Equipment
Course Series: eComply Healthcare

Description:

According to government estimates, from April 1, 2005, through March 31, 2006, suppliers of durable medical equipment (DME) received $700 million for claims that were either improperly documented or lacked proper evidence of medical necessity.

Medicare cannot legally reimburse a claim for DME unless a physician certifies that the DME meets the legal definition of "medically necessary." A physician or DME supplier who fails to adhere to the rules for proper certification may be subject to severe sanctions by the government.

This course discusses the elements of a legally proper certification of medical necessity for DME. At the end of this course, you will be able to:

1. List the regulatory requirements for physician orders for DME

2. Explain the significance of a physicians signature on a certification of medical necessity attestation

3. Recognize situations that may perpetuate fraudulent claims based on certifications

4. Describe the relationship between improper medical necessity certifications and the anti-kickback law

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Global corporations, private publishers and eLearning courseware distributors are discovering how CourseAvenue is making eLearning courseware development less complicated.

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