Kim Brummett
Dealer/Provider: What do you say to providers who are hesitant and/or fearful of trying new and different software technology?
Brummett: All of us need to keep an eye on what is out there in the industry. If you think you are interested in switching, go see a shop that is using it. Don?t just make a phone call, but go see it in operation. If you go on-site to a provider that is using the application, you are going to learn more about the challenges or the issues with support, and about what the system does not do well. You won?t hear these things from the vendor.
Dealer/Provider: How can the appropriate software help providers deal with changing power wheelchair codes?
Brummett: It is important for vendors to be aware of the new requirements. The new thing they’ve got going now is that we have to do part of a CMN [certificate of medical need] for the wheelchairs, but we do not have to have the physician sign it, but then we have to get a written order that needs to contain certain items. That is a huge issue for our software applications; even the homegrown ones don’t have the ability to produce both documents, which is what we are having to do. From a vendor’s perspective, it is about being aware of what those requirements are and bringing more to the table—and helping us get there—as opposed to waiting for a provider to call about a new regulation.
Dealer/Provider: Among the people you spoke with at the recent Medtrade show, what was the primary billing and/or software concern that you heard?
Brummett: For billing, it was the new rehab codes. It was pretty interesting because the Friday before CMS had announced that they were delayed. I think a lot of people went to Medtrade to learn something they no longer needed, or were going to speak on something that was no longer as critical a topic.
As for software, attendees were looking to see if there was anything new, better, or different out there—and there really is not. It’s the same debate—“Do I give up what I know—even though I don’t like it—for what I don’t know in a conversion?” That is always tricky.
Dealer/Provider: Among HME providers, what is the most common misconception about billing and reimbursement software?
Brummett: I think most people don’t use software fully or they don’t like how the application works. So instead of looking at their process and changing it to use the system more fully, they put manual processes around their software, which are just so costly. I see so many times when the inventories are not set up right, pricing tables are not right, and people are just doing all of these manual things because they have not taken the time to make sure their database is set up right or they know how to use it.
Dealer/Provider: What should providers avoid when choosing the appropriate software?
Brummett: You need to look out for what we call “vaporware.” We are starting to see a lot of Web-based applications where there is no IT [information technology], and no database sitting at the provider’s—everything is housed somewhere else, and it is cheaper and easier. There are a lot of new guys doing that, so you just need to be careful and make sure that whoever you choose has some history or some understanding of the industry.
There is nothing more frustrating than trying to convince a programmer of what you need programmed when they don’t understand how the business works. I would look for a software vendor that had a little bit of history. When they say they have got features, make sure they have got them before you buy it. Just understand that you are going to balance the tried and true with cool gizmos such as interfacing. Most of what we do is predatabase [work], and using a mouse when you are keying in data actually slows you down. From a sales perspective, it looks really good, but that tab key works just fine for most of us. DP
| Just the Fax? While it may seem like an “old” technology, many physicians prefer to receive paperwork (including CMNs) by fax. By Kathryn Starnes-Kiely  Kathryn Starnes-Kiely
ME providers have more choices than ever in how to distribute certificates of medical necessity (CMNs) and prescriptions to physicians. But not everyone has access to electronic CMN (eCMNs) options. Mailing takes time and in many cases can result in the doctor’s office “misplacing” the paperwork. When hand-delivering is not convenient, faxing can provide a quick and efficient means to quickly get paperwork to the physician and back again. What are the facts regarding faxing CMNs? CMS (in its Program Integrity Manual, Transmittal 11, Change Request 1773) authorized the faxing of CMNs and prescriptions. A patient must have an effective date of service on or after September 24, 2001. For CMNs, both the front and the back (11/99 version for O2 CMNs) must be faxed to the physician. • A provider must keep a copy of the facsimile transmission report, as well as any documentation faxed with the CMN, in the patient’s file. For example, a provider would keep a fax cover sheet, the DMERC CMN cover letter (if used and verbal confirmation is obtained), the DMERC CMN (front and back), and the fax confirmation page. If the physician’s office faxes back only the front of the completed CMN, that will be sufficient. But the provider needs to maintain that front side in the file and be sure to maintain the original fax—the original front and back of the CMN—which was sent to the physician. If a CMN is returned incomplete or with changes without the physician’s initial and date, it is acceptable to fax this signed document back to the physician. But the corrected CMN must now be mailed back or picked up in person. It cannot be faxed again. Why? It was determined that a document can be faxed three times before becoming illegible. Follow this scenario: you have faxed the CMN to the physician and the physician has faxed it back. If it was compliant, you would be done. But there may be a problem. Perhaps the physician did not initial and date a change. Now you can fax the CMN one additional time. That makes three faxed copies. The correction can be done by the physician on the faxed copy, but now the fourth will have to be mailed back or picked up due to the fact that it is now considered unreadable if faxed again. Providers must also make sure that the physician’s signature and date and the CMN form number and version date (lower left corner) are not cut off on the fax copy. Shrinking the CMN on a copier to 95% to 93% makes these occurrences less frequent. The documentation for the patient file then would include:
• the fax cover sheet to the physician;
• the CMN cover page (confirmation of verbal order if used);
• the CMN front;
• the CMN back (check to make sure it is the correct back!); and
• the fax confirmation page showing the number of pages faxed to the physician. When all of this is stapled to the returned and completed CMN, the provider now has documentation (proof) that the physician did receive the entire CMN package with both the front and back of the CMN. Many physician’s offices prefer to receive their paperwork via fax. By putting these procedures in place, a provider can fax the CMNs—thus saving time and money. By knowing the facts about faxing, providers can be confident that their paperwork is in compliance with CMS rules. DP Kathryn Starnes-Kiely is the president of Carillon Resources, a consulting firm (and member of AAHomecare) with offices in Indiana and Florida. Prior to her current position, Starnes-Kiely was manager of acquisitions for Apria Healthcare. She can be reached via e-mail: kathryn_kiely@yahoo.com. |
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