The 2014 HME Handbook: Accreditation
How to Renew Your Accreditation with a Team Approach
Accreditation is a key aspect of any HME provider business doing business with Medicare, but it is one that providers now must be revisited on a regular basis. Providers must regularly renew their accreditation, and often times they will want to incorporate new lines of business, which also requires accreditation per Supplier Standard No. 25, which requires that if a new product line is added after enrollment, the DMEPOS supplier will be responsible for notifying the accrediting body of the new product so that the DMEPOS supplier can be re-surveyed and accredited for the new products being added.
Because most providers want to be accredited as quickly as possible, they will want to make the process as smooth as possible. Many providers might recall the significant amount time required in order to obtain their original accreditation. Fortunately renewing accreditation for existing lines is much simpler, quicker process, and they can apply their experience to ease the process in getting accreditation for new business lines.
And that’s important because in today’s environment, where providers are seeking to diversify revenues beyond Medicare, the policies and procedures that they put in place to adhere to accreditation become a true business advantage. They can use these standards to drive the kind of excellence that will make them attractive to new types of customers and referral partners. Let’s examine some key things you’ll want to do to ensure the renewal process goes smoothly:
Recruit Your Team
The overarching principle in renewing accreditation is that it should be a company-wide undertaking. All members of the team must be involved in the process and take ownership in ensuring its success. Because the accreditation process is time-consuming and incorporates detailed work, everyone must be involved. Appoint a project manager and department leaders who can then work with team members to the task of implementing the standards throughout the organization. But before diving in, make certain the organization understands the imperative to pass renewal. For employees that have been around the process before, tell them about any changes. For new employees, 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.
Review Your Plan
As you renew your accreditation, you will need to have a mast plan in place. Chances are you might have done this in earlier instances of getting accredited, but your entire business should operate under an overarching outline of all the accreditation standards. These standards should apply to single process carried out by any department at any time. Having this master accreditation provides you with an easy way to review and ensure compliance at any time. Many accrediting organizations offer lists that can help you create one that can be tailored to your business, but it can serve as a good guide to create this business-wide outline. As you approach renewal, review your master plan and ensure that is covers all aspects of your business, old and new.
For any new employees who have not experienced accreditation, or if you are adding new lines of business that will require additional accreditation, or if your accreditation organization has expanded its standards for your existing accreditation, your team will need to be ready. They must be trained in new policies and procedures being put in place. This could even entail the addition of new credentials on your staff, so you will need to ensure your staff has the necessary certifications and licensure, and that those credentials are up to date and have sufficient CEUs. Moreover, if you are expanding geographically, then the staff at new locations will need to accredited, and that could entail unique requirements for those employees. For instance, different states have different requirements regarding required certification or licensure for providing different types of care of service.
Documentation is King
CMS’s ramping up of RAC, CERT and ZPIC audits, as well as pressures such as the face-to-face requirement mean that providers need to have their documentation ducks in a row. And, accrediting organizations will be monitoring this with a careful eye in order to ensure your business is safe from the threat of pre- and post-payment audits. The risk is simply too serious and the right documentation procedures must be in place. So, as a special part of your accreditation renewal, you must highlight the fact that all departments need to adhere to their required documentation procedures through the entire claims and care process — from having the right documentation from physicians on claims to patient signatures on delivery tickets.
Anticipate the Site Survey
Perhaps the culmination of the accreditation renewal process is the site survey. Like a pop quiz, you might not know when it is going to happen, but you can at least be prepared. If the accreditation standards outlined by your accrediting organization are indeed part of you business’s regular operating procedure and are second nature to every employee, then you should feel confident you’ll pass with flying colors.
Points to Remember:
- Renewal is a regular part of the accreditation process, and it is important to take the same care you did the first time.
- Appoint a project manager and various department leads to ensure all staff achieve on their accreditation objectives.
- If staff needs new training or certification as part of the process, ensure that they get it.
- In light of Medicare audits, the documentation aspects of accreditation are particularly critical.
- The best way to be ready for the inevitable site visit is to ensure the organization lives and breathes accreditation requires 24-7.
- There are a variety of accrediting organization that can help HME provider businesses obtain not only Medicare accreditation, but accreditation for private payor insurance carriers. Check out our online list of accrediting organizations.
This article originally appeared in the June 2014 issue of HME Business.