DME Hospice Per Diem Carveout Auditor
$935.00 in prohibited standalone DME equipment charges stripped from hospice invoices across across 2 items.
Bariatric mattress billed separately for $650.00. Exhibit A Section 2 defines specialty mattresses as 100% included in daily capitation fee.
Method1Audited itemized equipment invoices against capitated hospice master service formulary.
2Generated formal vendor credit memo demand for double-billed equipment lines.
| Reference | Description | Disputed_Charge |
|---|---|---|
| PAT-402 | Prohibited Standalone Bariatric Mattress Fee | $650.00 |
| PAT-404 | Prohibited Standalone Suction Machine Fee | $285.00 |
DME supplier monthly rental statements, plus hospice Medicare per diem carveout rate agreements
DME hospice dispute ledger and supplier credit memo request (Resolution Dossier, Findings Schedule)
Run DME Hospice Per Diem Carveout Auditor free on the last 12 months of files. If it finds money, the fee is 15 percent of what is actually recovered, nothing on what is not. After that, ongoing monitoring is $1,250 a month. 30% goes to the referring partner.
Read in memory for the session, never stored, never used to train a model.
Not medical, clinical, coding or regulatory advice. A qualified healthcare, coding or regulatory professional must review every result. Letters, notices and legal analysis are drafts, not legal advice. Have a qualified lawyer review them before they are sent or relied on.
Free scan. Pay only on cash recovered.
Run DME Hospice Per Diem Carveout Auditor free on the last 12 months of files. If it finds money, the fee is 15 percent of what is actually recovered, nothing on what is not. After that, ongoing monitoring is $1,250 a month.
On a sample file: $935.00 in prohibited standalone DME equipment charges stripped from hospice invoices across across 2 items.
Why not just use ChatGPT?
Rules that stay current: the rate cards, tariffs, code sets and regulations it checks against are kept up to date for you; a one-off prompt starts from nothing each time. Evidence that stands up: every finding cites the line, the file and the rule, so it holds up with a vendor, a payer or an auditor. The same answer every time: the checks are written rules, not a fresh guess, so this month's result can be compared with last month's. Nobody has to own it: no one inside has to build, test and maintain a home-made tool, and files are not pasted into a public chatbot.
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If you would rather talk it through, write to dev.sathya@baseloom.app; that reaches Dev Sathya, founder.