Technology will bring physicians and DME providers together

Date Published: March 02 2015

It all starts with DME providers showing practitioners how easy it can be to produce accurate face-to-face notes and seven-element orders.

The plight to obtain accurate documentation from practitioners has been burdensome for providers and frequently described as the ping-pong effect. Historically paperwork goes back and forth between the two entities several times before it is complete. The prior authorization demonstration for power mobility devices prompted a sense of urgency for physicians and providers to work together to ensure that medical necessity is accurately identified and documented the first time.

The 69% decrease in beneficiaries receiving a power mobility device between September 2012 and June 2014 is not insignificant. Peggy Walker explained in her HME News article "mistakes vs. fraud" that few providers in the DME industry intentionally bill for items they did not provide, or are providing items that that are not truly medically necessary. However, fraudulent providers do exist and while they are the exception, they have not helped portray a trustworthy and reputable image of DME providers. Trust has been one of the biggest hurdles providers have had to overcome when attempting to educate physicians about Medicare's coverage criteria for DME. That, and the fact that the best documentation solutions are standardized online tools that require the physician to try something new. We can't blame them for not wanting to add one more thing to their plate and many physicians are choosing not to prescribe PMDs as a result. It is believed that the 69% decline in PMDs in the seven original PA Demo states is largely a result of this. We believe the wheel is turning. There are now viable tools for physicians to utilize that take the uncertainty out of face-to-face documentation.

Standardized online documentation tools such as have bridged the gap between physicians and providers. These tools provide all parties with the opportunity to play by the rules and work together to help the patients get and keep equipment they qualify for. Our programmers are committed to building the algorithms that incorporate the coverage criteria and take the guess work out of the face-to-face documentation requirements. In 2015 we will see even more providers and physicians gravitating toward solutions that meet the stiffer documentation scrutiny. 

This year, we have a team going to provider locations all around the nation to see firsthand how they are succeeding in obtaining accurate documentation from their referral sources. We will post what we learn on Twitter and the news section of our website.

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