2016 HME Handbook

How to Approach Accreditation Renewal

Given the benefits of accreditation, it’s important that providers get the most that they can out of renewal.

Accreditation RenewalAs many HME providers know, Medicare accreditation is not a one-time process. Accreditation for billing Medicare for DMEPOS claims usually lasts for three years (although there are some instances where an accrediting organization might require renewal sooner than that), and once those three years have passed, the accreditation must be renewed.

The main reasons for renewal are to ensure that the provider is maintaining the correct and necessary policies and procedures, as well as to ensure that if the accrediting organization has changed any of its standards that the provider meets the revised requirements. So, every three years the provider is called upon to undergo the process and make sure everything is ship-shape.

And that’s not a bad thing. Given the exposure that providers have to a variety of audit programs, it’s a wise idea for providers to ensure that they have implemented the correct documentation policies and that they are following them to the letter. Also, accreditation helps providers implement workflows that not only follow the right procedures, but work smoothly when interfacing with referral partners and other healthcare professionals. This gives providers a strategic edge in terms of their level conscientiousness and dependability and bolsters their credibility and reputation in their local healthcare marketplace.

So, given the benefits of accreditation, it’s important that providers get the most that they can out of renewal. That said, accreditation renewal is a detailed undertaking that can consume considerable time. How can providers approach renewal to help it go smoothly?

Start picking your team. While it may have been a while since you last got accredited, remember that accreditation is a time-consuming process and involves considerable detail work. You need to form a team of key staffers who will approach accreditation renewal with the level of intensity your company probably did when first applying. Once you’ve identified the right people, make sure that not only those staffers, but the entire business understands that the company will be renewing accreditation. 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.

Select a team leader. The last thing you want to do is have your accreditation effort get bogged down by decision-by-committee. Identify an expert on your staff who you can trust to lead this effort in a hands-on fashion. You want someone who is ready to work with your accrediting organization to thoroughly understand the needed documentation policies and procedures and will be familiar with how they fit into Medicare accreditation requirements, as well. That leader should also identify and work with key team members in the business who can help implementing company-wide compliance, review workflows, determine how procedures need to change, and implement those changes.

Educate your leader and team. While you might have had Medicare accreditation for several years, changes are your accrediting organization has expanded or altered its standards for your existing accreditation. So, your team will need to be trained in the new policies and procedures. This could even include new credentials. Work with your AO to ensure your staff has the necessary certifications and licensure, and that those credentials are up to date and have sufficient CEUs.

Map out your business. It might seem a strange question to ask yourself, but do you truly “know” your business in terms of all its workflows and processes? Moreover, do you know if all those workflows are truly in compliance with your AO’s standards? Your entire business should operate under all your AO’s standards for every process carried out by any department at any time. So, if you haven’t done so already, your accreditation team needs to map your business and ensure every required department and function is adhering to those standards. Many accrediting organizations offer lists that can help you do this. Your team should to work with your AO to go over that list and apply it to your business.

Review all key business changes. Since your last accreditation renewal, your business might have seen changes. Have you expanded geographically? Have you added new categories? Have you acquired another provider’s business or part of that provider’s business? All these factors will impact your accreditation and the policies and procedures to which your business must adhere. While you might have made accreditation part of your initial due diligence during these events, you want to ensure that your renewal team reviews with your AO to ensure that your business meets all the necessary requirements as part of the renewal process.

Ensure you’re prepared for your site survey. As you know, your accreditation renewal will eventually involve a site survey. This is why the accreditation standards outlined by your accrediting organization need to be your business’s regular operating procedures and workflows. Consider conducting an internal site survey. With the help of your internal experts, you can implement a “site survey” of your own to assess business processes in the same way a site inspector would and measure proper compliance. Since you know the site survey is coming already, this will give you a good chance to internally review how you are preparing and where you need to improve. Also, once you know the survey is coming, make sure you manage 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.

Think strategically. Last but not least, don’t sweat the accreditation renewal process. You already know that your business has received your AO’s stamp of approval before, so the process shouldn’t be nerve wracking. If anything, it should afford you an opportunity to review your operations and see how adding the right policies and procedures can give you a strategic advantage in terms of correct documentation, clean claims, reduced exposure to audits, and an increased reputation for professionalism and reliability with your referral partners and patients.

Points to Remember:

  • Accreditation usually occurs every three years.
  • A good way to offload the hands-on elements of renewal is to identify a renewal team on the organization and appoint a leader.
  • Ensure the team gets the right training and updates from your accrediting organization.
  • The team should map out the business and work with the AO to ensure all departments adhere to the right policies and procedures.
  • Ensure that your accreditation renewal takes into account all recent changes that could impact the process.
  • Be ready for your site survey, have your key team members in place, and consider conducing the equivalent of internal “site surveys” during your preparations to see how you are measuring up.

Learn more:

This article originally appeared in the June 2016 issue of HME Business.

About the Author

David Kopf is the Publisher and Executive Editor of HME Business and DME Pharmacy magazines. Follow him on Twitter at @postacutenews.


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