Without CMNs, providers cannot rest easy

YARMOUTH, Maine -Since the demise of the certificate of medical necessity (CMN) for hospital beds, providers like Tyrrell Hunter report that collecting documentation from physicians has been a "pain in the neck." "When we get a call for a bed, immediately, we think, 'How are we going to get the documentation?'" said Hunter, president of Majors Mobility in Topsham, Maine. "At least with power mobility, there's a specific progression. You go from a cane to a walker and so on. Also, with power mobility, you're often working with physical therapists, so you have more of a chance to get appropriate documentation." Since CMS eliminated the CMN for hospital beds in October 2007, providers have played tug of war with physicians who aren't used to including specific mobility information in their chart notes. During a hospital discharge, documentation can be an "afterthought," Hunter said. The process has grown so cumbersome that Majors Mobility has considered taking hospital beds unassigned. But then the provider feels its referral business would dry up, Hunter said. One of the things providers can do: continue educating and developing good relationships with physicians. Provider Dan DeSimone gives his referral sources binders that contain documentation requirements and other information specifically for hospital beds. "For some orders, you have all the documentation you need and you can bill immediately; for others, you have to go back," said DeSimone, CEO of Continued Care of Long Island in Farmingdale, N.Y. "You don't really have an alternative." Provider Mark Ehlers eases the pain by supplementing his Medicare/Medicaid business with rentals. "We still take assignment but we also rent eight to 10 beds a month privately," said Ehlers, owner of Ehlers Health Supply, in Stockton, Calif. "Not everyone wants to mess with insurance."