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Physicians face new rules for durable medical equipment orders

A talk by ascanlecl

About the Talk

August 21, 2014 10:00 AM

AXIS Capital group a Direct Lender providing quality equipment leasing/financing services along with superior customer service headquartered in Grand Island, Nebraska, a Direct Lender providing quality equipment leasing/financing services along with superior customer service. The company offers quality medical equipment. The company serves people in many countries in the world including SE Asia such as KL Malaysia, Bangkok Thailand, Jakarta Indonesia and many more.

There are periods when this practice needs to order supplies for patients through a Durable Medical Equipment (DME) provider. Some recent changes to these rules, now the question is: do the changes affect the ordering physician?

Many physician offices possibly didn’t take notice of the requirements, considering they only affected the DME provider. Yet, they also affect the ordering physician. Warning! Be aware of scams and other fraudulence acts.

The new regulation is detailed in Medicare’s Learning Network (MLN) Matters Number MM8304, updated June 28, 2013.

MM803 reads: “The law requires that a physician must document that a physician, nurse practitioner (NP), physician assistant (PA) or clinical nurse specialist (CNS) has had a face-to-face encounter with the patient. The encounter must occur within the six months before the order is written for the DME.”

The date of the written order must not be previous to the date of the face-to-face encounter, and the face-to-face encounter needs to document that the recipient was evaluated and/or treated for a condition that supports the DME item(s) ordered. The Centers for Medicare and Medicaid Services (CMS) trusts this new requirement will lessen the risk of fraud, waste, and abuse as these visits help certify a patient’s condition warrants the DME item.

Throughout the face-to-face encounter, the physician or other qualified healthcare professional needs to assess the patient, run a needs assessment, and/or treat the patient for the medical condition that supports the require item for each covered DME.

Documentation in the medical record needs to comprise the identity of the practitioner who ran the face-to-face assessment. A written order is mandatory for covered DME items.

Failure to meet the requirements will cause in denial of the claim so it is always advisable to review your claims first.

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