Physician Office DME Accreditation

I did see that on Friday and talked to The Joint Commission about their plans.  They are working on new standards for physician office and will be pushing CMS to require accreditation.  Of course that is how they make their living.

Accreditation of DME in a Physician Office

My previous company helped office based surgery facilities get accredited so that they could bill and collect a facility fee.  They also helped negotiate contracts with private payers such as United and Aetna.  Last year we started Accreditation Helper to help DME providers get accredited and ultimately our goal is to help them get into the networks of the private payers also.

An interesting new situation is that we are being approached by physican offices that want to get their DME operation accredited.  Apparently in the past physicians felt that they could dispense DME products without being accredited, but CMS has now made it clear that anyone wanting to bill Part B for products and services that come under the heading DMEPOS, which stands for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies must get accredited.

With reimbursement shrinking everywhere I am sure that we will see a large number of orthopedic and podiatric offices wanting to tap into this revenue stream.  It could set up a awkward situation for those physicans who formerly referred these patients to a DME provider.  Of course the DME provider has a new challenge here also.  After nearly forty years in healthcare I shouldn’t be surprised at the the byzantine nature of this sector but here is another example.

Making Accreditation Pay For You

Unlike competitive bidding, accreditation is not going away.  Accreditation is synonomous with quality and everyone is in favor of quality.

So you will have to get accredited but it does not have to be a burden.  Done correctly accreditation can make your business operate more efficiently, increase staff morale, raise your image within your community, and make you more money.

That sounds like a tall order but in my seven years of helping healthcare facilities get accredited, 90% have reported these improvements after going through the accreditation process.  There are always 10% who don’t get the message, but we will assume that you are not in that group.

How does this work?  Good business processes need to be embedded in your organization through written policies and procedures.  This is the core of the accreditation process.  Employees need to know these, follow them in their daily duties, and know where to find them when they have questions. 

Quality improvement is an essentil element of accreditation.  As you are working on QI you will acquire data which will tell you the level of quality you have achieved.  This can be used to tell payers, patients, and providers that you are a high quality organization.

By networking with other accredited DME companies it is possible to get private payers to admit you to their networks.  This quality network can also bring new revenues to you from referring physicians and hospitals.

My next blog will talk about why you should get accredited by the biggest, oldest, and best recognized accrediting body, The Joint Commission or JCAHO.

Competitive Bidding Postponed?

The house today voted to override Bush’s veto of the Medicare bill which contained a postponement of national competitive bidding.  If the Senate follows their previous vote DME providers will get an 18-24 month reprieve.  I hasten to point out that accreditation is affected only for those in the 70 MSA who were required to apply by July 21st and get accredited by January of 2009.  The final date of September 30, 2009 is still in place and any new providers will require accreditation before they can get a supplier number.

In general everyone I talk to has accepted accreditation as a necessary and reasonable requirement for DME providers.  The two major short terms benefits will be driving the bad actors out of business as well as the very small providers who were basically dabbling in DME as a side line of business.  This could result in as many as 40,000 fewer supplier numbers in the industry which should be beneficial to the survivors. 

I will write next on the potential impact of accreditation on a provider and the beneficial aspects of accreditation above and beyond getting to keep your supplier number.