Spring in to Action with Education!

Date Published: April 03 2015

Catch the Spring fever! Show your doctors how to complete accurate face-to-face documentation the first time.

When practitioners use online algorithmic templates during face-to-face exams for durable medical equipment, they can rest assured paperwork is compliant. DME providers receiving the referral can rest assured documentation will pass Medicare's scrutiny.

In 2013 the Centers for Medicare & Medicaid Services (CMS) announced delays to the enforcement of face-to-face requirements from the Code of Federal Regulations at 42 CFR § 410.38, deeming this period the “time to establish operational protocols.” CMS refers to operational protocols as those internal processes established by collaboration of DME suppliers and physicians to ensure compliance with the face-to-face encounter requirement for certain DME items (see MM8304 for complete list).

What do your operational protocols look like, a year and a half later? Your organization is unique in size, market, and geographic area and the specific operational protocols established by your organization will be unique also. However, there exists a commonality between all DME suppliers when a new rule such as the F2F is established, and similar implementation issues, internal processes and education will be experienced by all organizations. The most important operational protocol for all stakeholders with the face-to-face rule is EDUCATION!

Many DME suppliers are now conveying to all stakeholders the importance and basics of the face-to-face rule. They are educating referral sources, clients, and especially employees. The rule itself is really not that complicated. It's imperative to thoroughly educate and train your staff about the intricacies of the face-to-face requirements for your commonly vended DME items. CMS does a great job compiling the top reasons for non-compliant documentation. Use these compilations of documentation errors to your advantage and ensure that your staff is aware of, and can be on the lookout for, common documentation problems. Empower your staff not just with WHAT they must do, but WHY it is important to your organization and how vital their particular role is to overall compliance within your organization. For example, if the person that retrieves faxes off the fax machine knows that a physician’s signature needs to be legible, a common documentation problem could be addressed as soon as the documentation is received from your referral source.    

Learning the in’s and out’s and keeping on top of changing face-to-face requirements is not a high priority for most referring practitioners. DME suppliers need to keep on top of changes by using informative websites and by providing referral sources with tools that track and educate them about the face-to-face requirements and any changes. One operational protocol that many DME suppliers have instituted is having someone or a department in your organization in the "physician liaison" role, providing an educational conduit and nurturing the “relationships with referral sources.” Many DME suppliers have tasked their sales team with providing referral sources with easily accessible and readily available information via checklists, websites and online algorithmic templates, such as 

Doctors are busy and appreciate any opportunity to simplify the paperwork process. DME suppliers like introducing doctors to online algorithmic templates because they can bring their referring doctors a tool for the face-to-face rule, not problem paperwork. Not to mention that makes them better ready for audits and they can bill Medicare faster. 

One last note about algorithms. It seems like the word algorithm is not well known and therefore difficult to explain. An algorithm is essentially problem solving. Many providers are learning that a medical algorithm comprises a technology for decision support when it comes to DME. With medical algorithms built into the template, DME documentation is formatted correctly and all required Medicare data points are addressed. In conclusion, algorithms take the guesswork out of the documentation process for physicians who would rather concentrate on the medical care of their patients. 

This information is brought to you by Tips From The Trenches in response to FAQs from DMEevalumate subscribers. 



Back to news

What people are saying

" is the perfect solution to time management and accurate documentation," James Smith, M.D.