Paperwork wars

Thursday, June 9, 2011

WASHINGTON – Industry reaction is mixed about a new CMS checklist that guides physicians through the process of prescribing and documenting the need for power mobility devices.

"It's not helping—they still can't get it right," said Ron Burns, director of the rehab department at Springfield, Mo.-based CoxHealth Home Support Systems, part of CoxHealth. "We've got physicians that time out on the 45 days. We have to say, 'No, the physician wouldn’t comply with the correct documentation on this.’ There's nothing I can do. It's a paperwork war for us." 

CMS released MLN Matters Article SE1112, "Power Mobility Device Face-to-Face Examination Checklist," to improve compliance with the documentation requirements for face-to-face exams. It has six pages of information and a checklist on page seven. 

Scott Soderquist, president of Rehab Equipment Associates in Manchester, N.H., said he didn't think the checklist would help much, but he said, "Anything is better than nothing."

In a perfect world, rather than having CMS clarify the process, Soderquist would like the agency to reduce the overall paperwork burden. 

"Medicare does not train the physicians or the providers adequately and then they expect us to jump through an enormous amount of red tape to have things go through smoothly and efficiently," he said.

Laura Cohen, a PT and co-coordinator of The Clinician Task Force, said she has used the MLN Matters article to educate physicians and therapists about the process. The article includes helpful examples of what to do and what not to do.

"What I see as the main reason why physician documentation is inadequate is because it seems like they're briefed or coached to write the language cut and pasted from the coverage policy," said Cohen.

Possibly the best use for the article: Because physicians are unlikely to read it from start to finish, providers should use it as an education tool with physicians, says Peggy Walker, a billing and reimbursement adviser for The VGM Group's U.S. Rehab. 

"If you go to a regular family practitioner that has any common sense, and his patient really needs a power chair—if he cares at all, he will document," said Walker. "If he doesn't care, he won't."