Patient care, not paperwork

Monday, February 25, 2013

WASHINGTON – Is there a way to make the audit process more efficient and effective for home medical equipment providers? AAHomecare is on a mission to find out.

“That’s the best way to characterize our efforts,” said Walt Gorski, vice president of government affairs for the association. “We want providers to be able to focus on patient care, not paperwork.”

AAHomecare convened its Audit Education Workgroup in January to set the association’s agenda and priorities for 2013. 

AAHomecare’s short-term goals include resolving these issues, Gorski says: HME providers who are losing out on monthly payments from Medicare for claims that overlap inpatient stays; providers who are receiving duplicate audits; and providers who are receiving audits that are inconsistent with policies.

Some other points of contention: “The timeliness of reviews is key, and clear guidance on what it takes to get off an audit,” he said. 

The association is also building an “audit tracker” that will allow it to better assess the impact of audits on providers, Gorki says.

AAHomecare’s long-term goal: “Eliminating this requirement that we’re held to the documentation that’s in the physician’s record,” he said. “When you put providers in the position of having to justify the medical necessity of what the physician writes down, you’re playing Russian roulette. Documentation is an art, not a science.”

Gorski says AAHomecare’s efforts got off to a good start in January, when it met with the Government Accountability Office (GAO) to discuss problems with the current audit process. The association expects the GAO to issue a report on audits later this year.

“This is a very high priority for the association,” he said.