Face-to-face rule: Give physicians data points

Q. Do clinical templates have a place with the new F2F rule?
Friday, April 25, 2014

A. Yes. The right electronic template provides a dynamic, time-efficient and cost effective solution to succeed at the highest level with the face-to-face (F2F) rule in effect since July 1, 2013. 

CMS came out with guidance for the use of templates around the same time they announced the new F2F rule. CMS recognizes that an electronic template, which is part of the electronic health record (EHR), is a good way to allow physicians to have a standard method of documenting a patient’s medical condition. 

Practitioners are prolific technology adopters when it makes their job easier. An online algorithmic electronic template is the best way to ensure a physician adequately addresses all the data points required during the F2F encounter. Most of the top reasons for DME denials come from a F2F evaluation where a practitioner has not properly addressed a data point or question required by CMS. If practitioners do not know what CMS is looking for, it is very easy for them to skip over or omit specific information.

CMS wants to ensure medical necessity is documented for all items of DME. However, even a thorough, well-documented reimbursement claim can be found non-compliant if a single data point is missed. The most effective electronic template is one that has algorithms built into it that analyze and apply Medicare’s coverage criteria, and addresses each data point in every F2F encounter, resulting in compliant F2F documentation. 

The new F2F rule does not have to mean more paperwork and time expended—it just means making sure physicians specifically document all the data points and questions CMS requires. Algorithmic electronic templates help accomplish this task.

Michael Blakey is president of DMEevalumate.com. Reach him at 800-986-9368 or mike@dmeevalumate.com.