Survive first phase of PMD demo
WASHINGTON - The only way to survive the first phase of the power mobility device (PMD) demonstration project is to make sure your documentation is up to snuff, stakeholders say.
The first phase, set to go live Jan. 1, requires providers in seven states to go through a prepayment review process for PMD claims.
"Having good documentation doesn't negate the fact that they're going to have to put the product out and wait 20 days to get the results of the prepay review," said Elizabeth Cole, director of clinical rehab services for U.S. Rehab. "But it means they might not have to provide more information and wait longer to be paid."
Peggy Walker, a billing and reimbursement adviser for U.S. Rehab, says she sees the same documentation mistakes again and again.
One of the most common: bad handwriting.
"You've got to have legible information," said Walker. "If the information is not legible, then don't send it in. Get it corrected."
Some suggestions from stakeholders: Have someone in the doctor's office transcribe progress notes and have the doctor sign off on it; create a field for the doctor to print his or her name after the signature; and use attestation statements from the doctor verifying his or her signature.
Other common documentation problems: using incorrect codes and not completing the process within the time limits.
"Watch signatures, watch dates," said Walker. "And if it's not correct, don't give the chair to the patient."
Providers often protest that doctors won't send them referrals if they refuse to put out wheelchairs without correct documentation, Walker said.
But "it isn't going to do you any good to get referrals and then get denied," she said.
While they need to be prepared for the demo, providers should also continue to fight it, said Seth Johnson, vice president of government affairs for Pride Mobility Products.
"This is a major cash flow problem and many providers are still in transition from the switch from the purchase option to the mandatory 13-month rental," he said. "We're encouraging providers to reach out to legislators and consumer groups in their states."