How to Ensure Accreditation Renewal Goes Smoothly

While the accreditation rush from two years back might seem like a distant memory, it won’t be too long before providers need to call up their accrediting organization to renew their accreditation. In fact, they might already be due to renew. Moreover with the threats of CMS’s RAC, CERT and ZPIC audits looming like some form of bureaucratic sword of Damocles overhead, reasserting and reinforcing the rigid accreditation standards that ensured proper documentation policies and procedures might be just want the doctor orderedin terms of protecting providers’ claims.

And renewal isn’t the only reason a provider might need to re-approach accreditation. For instance, an HME might be expanding its business into a new line of DME it hasn’t yet touched, and need to likewise expand its accreditation. Similarly, an HME might purchase another provider business that provides different types of DME, and wants to bring it within its accreditation standards (even if it was already accredited with another organization).

Or, it might decide to go with a different accrediting organization that it sees as more beneficial. Remember, accreditation is not just about ensuring your business has been deemed fit to bill Medicare; to many providers the policies and business processes that get put in place during accreditation represent a strategic business advantage.

In any case, whether renewing, switching or adding accreditation, it’s worth reexamining some key things you’ll want to do to ensure theprocess goes smoothly:

Staff up. Remember that the accreditation process is time-consuming and fraught with detail work. This is not a part-time pursuit. Approach accreditation renewal with the same company-wide zeal you probably did when first applying. Assign a project manager and team members to the task of implementing the standards throughout the organization.

Get everyone on board. Speaking of staff, ensure that the entire organization understands that the company is undergoing another accreditation implementation. Outline why your business is doing this; what any changes will be; review how the process will work; explain how it might be different from before; and specify how the process will impact each department and what will be required of team members in those departments.

Train the team. If you are bringing on new or additional accreditation, or your accreditation organization has expanded its standards for your existing accreditation, your team will need to be trained in the new policies and procedures being put in place. This could even include new credentials. Ensure your staff has the necessary certifications and licensure, and that those credentials are up to date and have sufficient CEUs.

Have you expanded geographically? This too could also impact your staffing requirements or policies and procedures. For instance, different states have different requirements regarding required certification or licensure for providing different types of care of service.

Have airtight documentation. Besides accreditation, the aforementioned threat of pre- and post-payment audits is too serious to risk not having the right documentation procedures in place. Ensure that all departments rigidly adhere to their required documentation procedures — from having the right documentation from physicians on claims to patient signatures on delivery tickets.

Outline your business. The entire business should operate under an overarching outline of all the accreditation standards for every single process carried out by any department at any time. Having this umbrella policy of a sort provides you with an easy way to review and ensure compliance at any time. Many accrediting organizations offer lists that can help you do this. Your AO’s list might need to be tailored to your business (or the other way around), but it can serve as a good guide to create this business-wide outline.

Always be ready for your site survey. Don’t forget that the accreditation process involves that surprise exam of the site survey. Sure you know it’s coming, but you don’t know when. This is why the accreditation standards outlined by your accrediting organization need to be your business’s regular operating procedure and second nature to every team member. But it also helps to ensure you always have some pinch hitters in place. Try to arrange your staffing so that you always have some accreditation team leaders in place so that you always have an expert to interface with the site inspectors whenever they decide to come knocking.

Remember, you received your accreditation before, and you can do it again. If you revisit the process with the same zeal — or more — your HME business is sure to hold onto (or expand) its accreditation. Moreover, it will sharpen its business edge in the process.

Points to Remember:

  • Whether you’re renewing, switching or expanding your accreditation, this is no time to slouch. The process demands your and your team’s full attention.
  • Remember that accreditation means more than being allowed to bill Medicare; it means gaining a strategic business advantage.
  • Review all the policies, procedures, and documentation standards required for all departments.
  • Get staff on board and assemble an accreditation team that will manage the project. Ensure all staff members have the right education and certification.

Learn More:

This article originally appeared in the July 2011 issue of HME Business.

About the Author

David Kopf is the Editor of HME Business.

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