Page 24 - HME Business, February 2018

The Time is Now
procedures, Canally says.
“You want to make sure that the training is up to date;
that the processes are the same as what it says in the policy manual,” she explains. “You don’t want to wait until the accred- itor comes and says, ‘Well, the training isn’t up to date; this new guy isn’t doing infection control.’”
This could even entail the addition of new credentials on your staff, so you will need to ensure your staff has the necessary certi cations and licensure, and that those credentials are up to date and have suf cient CEUs. Also, if you are expanding geographically, then the staff at new locations will need to accredited, and that could entail unique requirements for those employees. For instance, different states have different requirements regarding required certi cation or licensure for providing different types of care of service.
Common Pitfalls
There are some common renewal mistakes that providers should avoid. For starters, Canally notes that “an area we see a high de ciency rate in” is ensuring that annual training docu- mentation is up to date. Also, she says providers need to make sure that equipment manuals are accessible to employees
so that they can ensure they are following manufacturer guidelines.
For Zacharias the most common mistake BOC notices is providers waiting until the last minute.
“Providers should submit their reaccreditation application within a minimum of 30 days prior to their expiration date – ideally, 90 days — in advance,” she explains.
“Also, reaccreditation is a good time to evaluate the service
Accreditation’s Strategic Value
DMEPOS accreditation isn’t simply a Medicare obligation; it can set your HME business apart.
It’s important to keep in mind how essential Medicare accreditation is from a broad busi- ness perspective. While Medicare accreditation means an HME can bill DMEPOS claims, other payers use it as a gold standard. So even if a provider isn’t doing much Medicare, it still needs to use that accreditation to ensure it will pass muster with private payers and health plans.
“Accreditation covers more than Medicare,” explains Sandra Canally, RN, president of deemed Medicare accrediting organization The Compliance Team. “We see a lot of Blue Crosses, a lot of managed care — the Aetnas, the Cignas, the big guys —will not only contact the accreditor to verify the dates of accredi- tation for a particular DME, but they will
also drill down into the product lines that they’re accredited for. In other words, they’re mimicking Medicare.”
The problem with that is that some providers see accreditation solely as an obligation that comes up for renewal every three years.
That’s the wrong way to approach the process. Obtaining accreditation demonstrates a provider is following all the right procedures
in terms of claims documentation, equipment handling, ensuring satisfaction, and doing the sorts of things that will help optimize patient outcomes. This, in turn, compounds a provid- er’s reputation with referrals and satisfaction from patients. Some examples of accredita- tion’s strategic value:
Patient Satisfaction. A key element of main- taining Medicare accreditation is to document patient satisfaction. However, documenting patient satisfaction, simply makes good busi- ness sense, because it can give providers the
kind of information they can use to improve their businesses. Implementing satisfac- tion surveys helps a provider business nd out whether or not it is meeting the needs of its patient clients, and to pinpoint problems that to be xed within the business so that mistakes are not repeated. Ultimately this feedback links back to care quality.
CMS looks to accrediting organizations to ensure that providers are using well-docu- mented surveys as a means to assure patient satisfaction. That said, CMS does not outline how AOs should instruct their providers on surveying their patients. Your AO will likely provide guidelines that track patient satisfac- tion for a variety of criteria, such as timely equipment delivery; that the equipment was ready to use; proper patient instruction on equipment use; the patient has all the neces- sary contact information for reaching the provider; the provider is answering questions and helping patients after delivery; and that the patient is satis ed overall.
Audits. Medicare accreditation can help considerably in making sure that providers collect the right claims documentation, so that they reduce their audit exposure, and increase their ability to quickly follow up on audit contractor documentation requests. Starting by ensuring the correct documentation for claims, accreditation helps show the provider follows the latest LCDs and keeps accurate and compre- hensive documentation at order intake and all the way through to proof that the equipment was delivered, along with the model, serial and manufacturer numbers of the item delivered.
Ef ciency. At a time when policies such as
competitive bidding are radically reducing Medicare reimbursement, providers nd them- selves at a painful crossroads: they must ensure that they are living up to the requirements expected of them, but they must also reduce operational costs as much as possible in order to ensure that they can still run a pro table busi- ness. This is where accreditation helps, because the process clearly outlines what providers need to be doing in every aspect of their business. From there, providers can start to map those policies and procedures to their work ows, while at the same time, working to streamline those processes where possible.
Business differentiation. When a provider obtains Medicare accreditation it is telling all of their referral partners that the provider meets or exceeds all the policy and procedure requirements that Medicare expects from a DMEPOS supplier in order to serve Medicare bene ciaries with the kind of care, consid- eration and product expertise that will help ensure that patient derives the expected bene ts from their equipment.
That is a huge market differentiator to not only referral partners serving Medicare bene ciaries, but also referral partners with private payer insurance funding, as well as the patients them- selves. Savvy providers will communicate this
to their patients and referral partners in order to distinguish their businesses as a respected and knowledgeable provider that can be relied on to provide dependable and expert service. When communicated correctly, this message will reso- nate with clients and referral sources and instill a sense of con dence that they are working with the best in the business.
24 HMEBusiness | February 2018 | hme-business.com
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