What’s going on with e-CMNs

Electronic document exchange (EDE), including the electronic certificate of medical necessity, or e-CMN, has been inching through the HME pipeline for several years. And despite most HME providers’ cautious attitudes about e-CMNs, developments such as the government’s authorization of electronic signatures and recent adoption of the technology by several prominent players have pushed this e-document into full view.

"The biggest opportunity to cut costs, improve profitability and increase efficiencies is in document management, period," says Dennis Nasto, vice president of sales, marketing and customer support for Austin, Texas-based SecureCare Technologies (formerly eClickMD), one of the industry’s largest EDE application providers and the developer of SecureCare and SecureMD. "The technology of EDE allows for a reduction in errors and lost documents and for greater efficiencies overall."

In recent months, Schenectady, N.Y.-based Trac Medical Solutions, which offers an e-CMN system called CareCert, has partnered with the American Association for Homecare to offer the product to its members. Apria Healthcare and The MED Group have also signed on with the company to provide e-CMN processing capabilities. The technology is definitely "cost-effective," says Jeff Frankel, TracMed’s president and CEO. "A provider’s activities-based cost of processing a CMN manually is $25 to $35 per CMN," he says. "Our cost is no more than $4 [per CMN], a significant savings. Second, you eliminate human error from this process, which has a direct impact on cost initiatives."

Nonetheless, using e-CMNs currently is not a feasible business tactic for most HME providers. But it’s not their fault. Physicians are the necessary—and the most reluctant—part of the equation in making EDE and e-CMN technology a standard procedure.

"The biggest challenge in implementing EDE with physicians is physicians," Nasto says. "Every provider understands the value proposition for their business. The question is, how do they get their physicians to want to do this?"

Both TracMed and SecureCare are tackling the issue through various tactics in an attempt to help providers realize the advantages of using EDE. TracMed is working on numbers, thus its marketing alliance with AAHomecare and a pursuit of provider organizations. Providers "have to be willing to embrace our support early on in this process and to identify the 20 percent of the physicians they do business with--which represent 80 percent of their business—and let us help them sell the physicians early on," says Frankel.