Providers of therapeutic support surfaces might not realize how
well positioned they are to truly help wound care patients and their clinical
referral partners with their DME offerings. Wound care patients require
specific therapeutic benefits depending on the type and severity of their
wound, and often referral partners are not aware of what’s available.
However, providers can sometimes feel a little trepidation when working
with clinical wound care professionals because the care of wounds requires
such dedicated and precise care. How can providers better cater to these partners
and patient?
The first hump to overcome is committing to support surfaces. DME providers shouldn’t treat Group 1 and Group 2 support surfaces
the same way
they might treat hospital beds, wheelchairs or walkers — they compete on
service. Competing on service may be an effective way to get more business in
some DME categories, but not in Group 1 and 2 surfaces. Simply filling orders will yield a disproportionate share of referrals.
Rather, provider must fully commit. No, they don’t need to be clinicians or know how to stage pressure ulcers themselves, but
they should understand the basics of staging and how that related to support surface options when staging is mentioned in the health records.
To that end, ICD 10 codes provide precise
information regarding pressure ulcers that make it easier for providers to
qualify beneficiaries for bed and seated support surfaces. The ICD-10 code for
pressure ulcer is L89, and that code includes specific location and
wound depth or stage. So, for example, L89.133 denotes a pressure ulcer of right
lower back, stage 3. Beneficiaries with L89.133 would qualify for and benefit from
a skin protection cushion (if they had and qualified for a wheelchair via Medicare)
and group 2 support surface.
Ultimately, It comes down to understanding the language and then understanding
what product solutions would correlate with that wound. And that’s
a good role for the provider to fulfill, because at it turns out their counterparts
on the clinical side of the fence can really benefit from the product knowledge
that engaged providers will amass. This
puts the provider in an excellent position to educate the clinician and establish
itself as an informed, expert resource.
In terms of education, providers don’t necessarily need special education or
certification on the team, but coverage knowledge will definitely in providing
knowledgeable services for both patients and referral partners. Providers should definitely understand coverage criteria and guidelines for health
record charting and documentation.
So, how to get started? Providers should ensure they fulfill three very basic
requirements to ensure they develop a successful referral partner education
program:
- Learn the medical justification needed to qualify a patient for both Group
1 and 2 surfaces and various cushions, so they can educate referring
clinicians. - Learn objective information about each support surface technology and
teach referral partners the advantages and limitations of each. - Understand how to match a specific product’s features to benefit a specific
patient population.
Ultimately, it all comes down to possessing rock-solid product knowledge
and being able to communicate that information to the clinician. This lets the
provider become an educator and a facilitator. And filling that particularly niche in a competitive DME marketplace is exactly
where smart providers need to be.