Paperwork burden beating providers to a pulp

HME providers have been slow to embrace the paperless initiative being championed by software companies, administrative specialists and financial advisors so far, but the movement may finally gain momentum with passage of the Medicare Prescription Drug Act's new reimbursement-slashing mandates. While providers may hope that Medicare reform's intent to pattern Medicare Part B after the Federal Employee Health Benefit Plan system will eliminate certificates of medical necessity and other documentation, regulatory experts say that isn't likely. “The gains made under Medicare reform are not with paperwork reduction but with due process issues,” said Steve Azia, partner in the Washington-based law firm Eastwood and Azia. Long identified as a key cost center for HME providers, paperwork saps vast quantities of time, resources and storage space, critics contend. As HME companies consider revising service levels, payer mix, staff utilization and product offerings, elimination of paperwork is yet another piece of the post-reform paradigm. “The costs associated with administrative processing of paperwork is very high,” said Dennis Nasto, vice president of sales for E-Click MD, San Diego. “Every time you manually handle a piece of paper it's costing you money.” Melbourne, Fla.-based financial consultant Wallace Weeks agrees. Although he hasn't quantified paper-handling costs in dollars or percentages, he said providers can easily do it themselves. “Look at how much is spent on copiers, fax machines and any other paper-processing equipment,” he said. “Look at how much time is spent physically transporting paper around the office. And when people encounter each other ‘en route,' it's human nature to want to stop and chat. It's clear to me that every office could benefit from the use of paperless technology.” Paperless systems that allow the intake, processing and filing of electronic documents are currently available through various HME software vendors. The applications handle electronic CMNs, service orders, invoices and other traditional hard copy forms. The paperless initiative has generated enough interest that AAHomecare scheduled a technology forum at its annual Leadership Conference to discuss e-CMNs and electronic 485 orders for home health care. AAHomecare Chairman Joel Mills is leading by example - his company, Advanced Homecare, has implemented a digital scanning system. “We are paperless for documentation and client folders - everything is now online so we don't have to constantly be transferring back and forth,” he said. Mills can't place a dollar figure on the cost savings from automation, but the benefit is apparent, he said. “It's helping us to think better on the HME side,” he said. One snag in the paperless drive is doctors' participation in the e-CMN process. Although the physician community hasn't seen any value in the process so far, Nasto believes that will change. “They haven't had the motivation to convert to e-CMNs because they need to be shown there's something in it for them,” he said. “But once they see this drive their operational efficiencies, they'll come on board. And as soon as they do, they'll be telling providers to go with a paperless system.”