CMS is adding 31 additional codes to the Required Prior Authorization List as a condition of payment. The complete list of codes and descriptions can be located here. The expanded code list is effective September 1, 2018.
CMS announced June 1 that it is adding 31 power mobility device Healthcare Common Procedure Coding System (HCPCS) codes to the list of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) items that require prior authorization as a condition of Medicare payment.
Items on the Required Prior Authorization List require prior authorization as a condition of payment. As such, lack of a provisionally affirmed prior authorization request will result in a claim denial.
For information about how Bonafide has updated its software for this change, access our Knowledge Base article on the topic. Note that this is password-protected; you will need to log into your Bonafide account in order to access the article.
For more resources from CMS, please access see the following documents:
You can significantly expand your DME business with nursing home and hospice contracts, but only if you do it right.
A single LTC contract could expand your customer base by 300 or more patients, but with super-tight margins, those 300 patients could cost you more than they earn. The only way a DME Provider can use LTC contracts to increase revenue in today’s environment is to have technology that streamlines the process and eliminates costly overhead and errors.
LTC contracts provide new and significant revenue streams to DME providers and a reliable customer base with a constant need for sales and rental products. And, of course, LTC contracts mean that you are invoicing, not submitting for reimbursement, which can significantly improve cash flow.
The danger in developing nursing home and hospice contracts is the process of taking orders. Having nurses phone into your business to place orders, service requests, deliveries, etc. can lead to errors and misunderstandings. These errors lead to costly penalties. With margins as tight as we’ve ever seen them, the cost of processing and correcting LTC orders can often exceed the revenue they generate.
The only way that DME Providers can benefit from the significant revenue potential from LTC providers is to have technology that automates and streamlines the order and delivery process. Bonafide is the only DME software company that offers an online portal for both rental and sale items.
The Bonafide Facility Portal allows nurses to directly:
This technology completely eliminates the need for nurses to call into DME Providers and engage in lengthy order processes. Nurses can take care of all the details on the DME provider’s web portal and everything is date and time stamped so that if there are errors, the costs for those errors don’t fall on you.
Additionally, our system can differentiate between per diem orders, rental orders, sale orders, fee for service items, and more. LTC billing is complicated, and we are the only system that can handle the complexity and ensure that invoices are accurate and backed up by digital time stamping so there are no questions after the fact.
Your Bonafide system automatically sends invoices once per month, further reducing your overhead costs for servicing LTC contracts. Of course, you need to have the warehouse and delivery infrastructure to fulfill your contracts. Bonafide has some awesome technology to help there, too.
Bonafide’s Facility Portal allows DME Providers to better service hospice and nursing home contracts. The portal makes it easy for your hospice and nursing home contracts to place orders themselves, eliminating costly steps and dramatically improving profit margins on these accounts. With the Bonafide Facility Portal, DME Providers can effortlessly serve more hospice and nursing home contracts.
The Bonafide Facility Portal makes it easy for nursing staff to order the items they need using your branded portal. Orders are instantly available in your Bonafide DME software for delivery, completely bypassing your customer service staff. Nursing staff can enter patient data and select items from an online catalog of items you have contracted for.
Your customers can order and make service requests using the Bonafide Facility Portal and it routes directly to your Bonafide software for scheduling. This includes equipment exchange and service. Our electronic delivery system means that you can send an invoice the moment the patient receives an order, eliminating expensive double-entry processes that can delay billing in other systems.
Bonafide customers that are using the Facility Portal report dramatically reduced costs, better order processing and improved visibility into what is happening with their drivers and customers.
Bonafide Management Systems has released Optical Character Recognition (OCR) functionality. This technology allows our customers to efficiently and instantly search all scanned documents on the Bonafide DME software solution. OCR is an advanced feature included at no additional charge to Bonafide customers. If you are a customer and would like this feature, please contact email@example.com so that we can turn it on for you.
Bonafide’s OCR technology works by analyzing the structure of scanned documents. The technology is able to recognize elements such as blocks of text, tables, and images. It can then identify characters and words within the scanned document. This search function eliminates costly data entry functions currently required in most Durable Medical Equipment (DME) businesses.
“We are adding this technology based on the fact that OCR will result in significant cost savings for our customers by reducing costly manual searches and manual data entry,” says Wayne Bailey, Director of Customer Service at Bonafide. “With DME margins shrinking every day, we are dedicated to providing critical cost-savings opportunity with our software.”
OCR technology allows Bonafide’s customers to search all scanned documents containing a specific name, hospital, phone number, diagnosis code, denial description, or almost any detail quickly and easily. The workaround for DME providers today is to manually add tags and descriptions to scanned documents, but these are often either incomplete or require a complete re-write of the scanned document. With thousands of scanned documents in any system, the cost savings posed by OCR are tremendous.
“Our customers have thousands of scanned documents, none of which are easily available,” says Michelle Tohill, Director of Revenue Cycle Management at Bonafide. “Manually reviewing documentation is time-consuming and unproductive because scanned documents are not dated or scanned in order and are not easily available. OCR will help our DME customers become more efficient in their documentation, compliance, and billing activities.”