Tools and Tips

Imagine being able to save more than $2,000 for every 100 Certificates of Medical Necessity (CMNs) you process. Imagine there is an easy and simple way to eliminate your seemingly endless paper trail. Imagine that there is a solution that will ensure authentication of medical records and save you time and money.

Life would be much simpler, wouldn't it? To achieve all of these goals, consider shifting your paper documents and processes online. It's a viable option that will increase the efficiency of your daily responsibilities and help improve your bottom line. Migrating to electronic processes provides you with a cost-effective and reliable solution that ensures Federal regulatory compliance and business efficiency. It provides secure documentation of medical records, while ridding you of the tedious manual process of completing and archiving paper forms. Here are some reasons to consider moving to electronic documentation and authentication and how to do so now.

1. Why Migrate to Electronic Processes.

Aside from the paperwork, no one wants to break the law. Complying with Federal regulations is imperative to both health care suppliers and physicians alike. Any and all submissions of Medicare or Medicaid claims must meet Federal audit standards. If they don't, you risk losing Medicare and Medicaid reimbursement and business relationships. In some cases, you could be put in jail. Yet, due to the high margin of human error associated with hordes of paperwork, some of the best organizations with the best policies, procedures and staff, can and do fail medical record audits.

By moving paperwork and manual processes to an electronic format and online transactions, you can achieve automatic and reliable documentation and verification of services, fees rendered and payment due not to mention significant cost savings.

2. Why Now.

With shrinking reimbursement from Medicare, Medicaid and other insurance companies, on top of an aging population, there is no better time to reevaluate your business and operational procedures. Within the next five to 15 years, the percentage of the population that will exceed 65 years of age will grow more significantly than any other age group in the United States. This will only add to the multi-million dollars worth of claims already being processed. For your organization to better handle the increasing number of claims, it is time for an upgrade.

3. It Is Your Ally.

As technology plays a more integral role in our daily lives, making the right IT moves is crucial to the life and success of your organization. Smart IT allows you to streamline your business processes, provide improved services to customers and partners and boost profits. The rising everyday and global use of the Internet combined with e-mail becoming the dominant form of communication has enabled health care professionals and organizations to take advantage of modern technologies, particularly documentation and authentication of electronic forms.

4. Help is Available.

To help bring documents online and reduce the paper chase, more companies are offering electronic services aimed at health care professionals. Currently, CareCert technology is the only fully HIPAA compliant platform that offers electronic auditing capabilities because it enables data to be captured and saved. Developed with the combined technologies of Trac Medical Solutions Inc. and AuthentiDate Inc., CareCert is an easy-to-use Web-based system that enables accurate, secure and complete electronic processing of medical forms. Sealed with the United States Electronic PostmarkĀ® (USPS EPMĀ®), the electronic forms are stamped with the same level of trust and security most commonly associated with First-Class physical mail. It's like taking a photo of the content which can later be used to prove the veracity of a document at any point in time.

5. Prevent Fraud With Extreme Prejudice.

Electronic processes can help your organization reduce the risk of fraud. Health care organizations spend approximately 20 to 25 cents of every premium dollar on fraudulent abuse. And in many cases, they don't even know they are committing fraud. To help combat this issue, programs weed out any documents that have been tampered with by preventing this kind of fraud from the get-go. With a time-and-date-stamp from the USPS EPM, the solution creates a permanent DNA for the e-document. Minor alterations, even adding a space or changing a colon to a semi-colon, are noticed immediately and will result in a refusal to verify the content. That means you can be assured 100 percent that the eCMN's content is safe and secure and has not been altered. This not only provides automatic content verification, but it also establishes a complete and accurate audit trail.

6. But I don't understand technology.

The good thing is that electronic documentation services are easy to use and have a fast learning curve. For example, CareCert is simple and processing a CMN online (eCMN) only takes a few steps. You can simply log on to the Web portal by entering a verified username and password and complete the eCMN online. An e-mail is automatically sent to the physician who originally prescribed the equipment to alert his or her attention. The physician can then provide an electronic signature for the eCMN which validates and completes the process for proper reimbursement of services? immediately. Throughout this process, the content within the CMN is protected and cannot be altered.

Think of it as you would an online airline reservation. You log on to the airline Web site with your username and password and then complete the reservation form online. You then receive an automatic e-mail confirmation that you can print out or e-mail to a friend. Whatever you do, the content is secure and cannot be changed.

7. The Bottom Line.

We have addressed how taking documents online can reduce paperwork and ensure tamper prevention and compliance, but the greatest advantage will appear in your company's bottom line. Utilizing electronic authentication services for documents will allow you to reap immediate savings and benefits. It generally costs suppliers between $18.00 and $22.00 to process a CMN manually. With CareCert, you can process an eCMN for as little as 87 cents. Depending on the volume and the size of your organization, eCMN's cost between 87 cents and $4.00. This is how you can save over $2,000 for every 100 CMN?s that you process?and ultimately, increase profits.

8. It's Already Happening.

For a real-life example of cost savings, consider members of the American Association for Homecare (AAHomecare) who are already using CareCert. AAH has approximately 800 member companies that operate in 4,500 locations throughout the United States. They process approximately 60 percent of the 52 million CMNs and Written Orders issued every year. This means programs like CareCert could potentially save this segment of the industry more than $600 million per year simply in processing fees associated with CMNs inclusive of significantly reducing manual labor hours and increasing business productivity.

9. Other Uses of Electronic Process.

Electronic documentation and authentication is that it can be applied to a variety of health care forms. For instance, in addition to eCMNs, CareCert enables an electronic version of the Home Health Care Form 485 (e-485) which is in beta stage. Similar to CMNs, Form 485 is required by Medicare for reimbursement of home nursing care services. The electronic version will address the needs of more than four million patients who require home health care nursing services, many of whom require multiple Form 485's throughout their treatment. The e-485 will also help drive down costs and improve operating and billing efficiencies for the home health agency sector which is comprised of 7,000 locations and generates approximately $30 billion in spending a year.

10. The Viral Effect.

Electronic processes are quickly catching on in the healthcare industry. Thousands of eCMNs are currently processed annually at TracMedical, and this number continues to increase, as additional suppliers catch on every day. Physicians can and are already taking advantage of electronic documentation for prescriptions, medical records and virtually any form that requires a physician's signature.

From preventing fraud and ensuring government compliance, to increasing efficiency and cost savings, electronic documentation and authentication services are quickly becoming a valuable component of the health care professional's daily life.

This article originally appeared in the July 2004 issue of HME Business.

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