Oxygen Equipment and Supplies: Breathe easier knowing your documentation is complete
By: Andrea Stark
According to a recent report from the Comprehensive Error Rate Testing (CERT) program, which reviews Medicare Fee-for-Service claims, medical equipment providers commonly struggle with insufficient documentation for oxygen equipment and supplies. Of course, failing to provide adequate documentation opens the door to even more audits and determinations of improper payments.
If you also struggle with this, the first area you will need to address is your process for collecting the required recertification certificate of medical necessity (CMN). After the first year of oxygen service (or the first three months for borderline beneficiaries qualifying initially at 89 percent), suppliers are required to obtain a recertification CMN to confirm that a medical need for oxygen still exists (CMS Form 484).
Once patients have the equipment in their homes, you must have a reliable system to ensure that expiring CMNs get updated in a timely manner. The best solution would be to create an outreach program through which you maintain contact with patients to coordinate the recertification face-to-face evaluation. In many cases, billing software systems can proactively monitor certifications that are nearing expiration, so your staff members can proactively notify patients of the need to recertify and provide the forms to complete the process.
After the recertification CMN, you will need to document ongoing medical need for the equipment on an annual basis for the remaining reasonable useful lifetime (RUL), as outlined below.
• Year 1—Covered by the initial CMN for the first 12 months for Group 1 patients
• Year 2—The recertification CMN covers months 13-24 for Group 1 patients
• Years 3-5—Medical need documentation must be collected annually
Can you really afford to make mistakes with your oxygen documentation? Errors in documentation ultimately result in claim denials and increased audit risk. Instead, proactively lead your business into the new year by ensuring your documentation is complete and compliant. For more information from Andrea Stark, click here. See how Mediware’s CareTend solution provides a complete document management system that ensures compliance.