Accreditation & Software
By Bently C. Goodwin
Summary: In order to make the accreditation process and
compliance with the quality standards easier, software programs can help. The
quality standards for accreditation require a vast amount of information to be
tracked and documented, and having the right software can be instrumental for
seamless business operations.
Providers cite many reasons for procrastinating on
accreditation. Some providers have put it off because the Centers for Medicare
and Medicaid Services (CMS) has not yet issued a final deadline for
accreditation. Other providers are hoping they are located in a city that won’t
be named for the next wave of competitive bidding. And other providers, after
reviewing the quality standards, may have determined that the process seems too
cumbersome to dive in and complete it immediately. No matter what the
reasoning, if providers want to bill Medicare in the future, accreditation will
Discussing the importance of providers seeking accreditation, Sandy Cannally,
founder and president of The Compliance Team says, “This is providers’
livelihood; it is their business.”
In order to make the accreditation process and compliance with the quality
standards easier, software programs can help. The quality standards for
accreditation require a vast amount of information to be tracked and
documented, and having the right software can be instrumental for seamless
Cannally says the number one way software and accreditation are connected is
through inventory tracking. “A lot of people out there still do not have
computerized tracking. We have an all-inclusive manual, but providers need to
get to the next, computerized, level. Providers need to know where their
inventory is at all times. In the event of any type of recall, providers need
to be able to identify where that serial number is at any given moment. That is
what an accreditor will look for.”
Software is also used for tracking maintenance and preventative maintenance.
Cannally says, “For example, ‘This is what happened with this concentrator.’
You can sort by due dates of preventative maintenance and find out when the
preventative maintenance is due next. The easiest way to track that information
is on a computer. We look at it from a standpoint: Can providers look for where
that serial number is? Does it show history on that machine? How many patients
have used that concentrator in the last three months? That’s what providers
need to look for in choosing a software package.”
Cannally says that software also helps with databases for physicians, by having
a place to verify physicians’ licenses.
Another connection between accreditation and software is claims monitoring.
Cannally says, “How often do providers have denials? Who are providers getting
denials from? Software can offer more than just equipment management when it
comes to accreditation, it also can offer corporate compliance and
Although some smaller providers do not currently have software systems,
Cannally recommends that most providers have software to cover the basics.
Generally two-tiered in terms of the expense, there is software that consists
of a basic package allowing providers to know where the equipment is, but there
is another tier of software that handles more comprehensive reports, history
and advanced tools.
“If a provider needs to do purchase software in steps, that’s fine too,”
Cannally says. “As they are able to, they can add that component. It is tough
to see any providers that aren’t computerized at this point, but we can give
them manual tools to use.”
Roberta Domos, RRT and owner of Domos HME Consulting Group, lists the following
ways HME software programs can help providers achieve accreditation:
- Tracking serial numbers of
rental items provided to patients for recall purposes.
- Tracking lot numbers of
oxygen or respiratory medication to patients for recall purposes.
- Tracking due dates, and
recording the preventative maintenance history of serialized rental items.
- Tracking prescriptions that
are about to expire to notify the provider that a new prescription is
- Tracking patient follow-up visits
so that they can be completed on time, according to company policy and
standard of care.
- Logging complaints as
required by accreditation standards.
- Aggregating and assessing
Medicare denials and coding errors through analysis of the ERN file.
Asked whether accreditation is gaining speed for providers
who suspect they might be named for the second wave of competitive bidding,
Cannally says, “We are definitely seeing an increase in interest. It is no
where close to where it needs to be, but we are getting there. Providers know
it is inevitable, but they don’t feel the urgency. I have told my people in the
field that when you are talking to anyone, look at the list of the 100 largest
metropolitan statistical areas (MSAs) and look at the top 80 and that is who we
need to focus on — after taking out the first 10 MSAs — look at the statistical
chances of the next likely cities.”
Cannally hopes that CMS gives more than six months when it releases the final
deadline on accreditation. “People need to know this: It is not just the DMEs
and the pharmacies that this affects, the Medicare Modernization Act of 2005
(MMA) is so far-reaching with accreditation, it also affects all the
podiatrists, orthopedic surgeons, nursing homes that do DME, maybe enteral —
food and nutritional services — the opthamologists, the anaplastologists, etc.
Now picture 10 accrediting bodies accrediting everything, there are only a
handful of us that can accredit everything. Not all 10 approved accrediting
bodies are approved across the board for everything. Providers need to look at
CMS Web site as it relates to the different accrediting bodies and what they
are approved to accredit. Some accrediting bodies might accredit prosthetics,
but not power chairs,” Cannally says.
Software Companies Discuss the Connection
- Generates reports and data
- Automates the process of new
- Provides detailed patient
- Tracks serial and lot
numbers, delivery of products, equipment maintenance and history.
- Tracks key product
- Tracks equipment maintenance.
- Offers complete history of
the lifespan of products.
“Accreditation for HME providers is essential today in order
to compete effectively in the home care market. From a patient safety
standpoint, Fastrack supports accreditation for HME providers specifically in
the technology that we utilize and leverage in the development of our software.
The ability to accurately track equipment history, maintenance and settings, as
well as education for patients and their families is essential to understanding
that equipment’s efficiency in the administration of various therapies. In
order to adequately understand the life performance of a piece of equipment and
whether it is safe and effective for patient care, bar coding, wireless
inventory tracking and delivery confirmation, providing for real-time
information on these pieces of equipment is essential. This is important not
only to patient care and safety, but to the health and growth of the business
overall.” — Spencer Kay, Fastrack Healthcare Systems
“Accreditation helps providers better understand and operate their businesses
more efficiently. To that end, accreditation includes helping HME businesses to
better manage their inventory and their accounts receivable. Accreditation will
also push HME businesses to utilize the HME software for more than just a
billing program to get claims paid. HME businesses will want to automate as
many features as possible.” — Jay Williams, QS/1
“Continuing Quality Improvement (CQI) is a big part of the accreditation
process. RemitDATA provides tools that allow providers to monitor reimbursement
performance and implement a continuous quality improvement process around the
reimbursement function. The tools allow internal benchmarking and industry
benchmarking. RemitDATA provides productivity tools that allow for process
improvement by reducing the time necessary for following up on denials and
processing secondary invoices. All of this empowers a provider to reduce denial
rates, reduce total time spent on reimbursement and accelerate cash flow.”
This article originally appeared in the December 2007 issue of Mobility Management.