Tracking PMD Documentation

Ever since CMS began its overhaul of the rehab coverage and pricing model, power mobility providers have found themselves confused and frustrated.

HME companies are unsure how to move forward, and many have more questions than answers. How do they respond to the new fee schedules and the required documentation? Which wheelchairs can they provide to their Medicare patient base and which are not allowed?

One particular area of power mobility device reimbursement that is causing suppliers to scratch their heads is the new medical documentation requirement. Providers are faced not only with the challenge of getting the required documentation from physicians in a timely manner in order to process the claim appropriately but also tracking it effectively.

Here are some tips that should help in gaining control of your PMD documentation process.

IT TAKES TRAINING

The first key element in getting control of the documentation process for power mobility is proper training. Companies must have at least one well-trained documentation employee on staff who has a firm grasp of what is required by Medicare.

This person must understand all of the requirements that the patient must meet in order for the PMD to be covered: the face-to-face requirement, the detailed written order, detailed product description, what is in the patient chart notes and how they all relate to complete the information circle.

Comparing the patient chart notes to the face-to-face and detailed written order is time-consuming and requires your documentation staff to be well-versed in the coverage requirements.

Training your staff is more than just reviewing the policy itself. The staff cannot simply read the requirements; they must have a complete understanding of their meaning and what it takes to comply. Without this knowledge, you will never be really sure whether your claims will stand up to the scrutiny of a post-pay audit.

If you don't want to do the training yourself, there are many industry conferences and presentations to which you can send your staff for training on this topic, and it is worth the time and money to do so. Or, check with your vendors. Many manufacturers also will be willing to help.

Also, set time aside to walk through the policy with your billing team to make sure your staff is interpreting it correctly. If confusion arises, discuss the concerns of team members and come to a company-wide agreement on how to interpret the policy.