Thank You to those who provided some new thoughts on this subject. I
appreciate it. It sounds like the forms that we are asking our doctors
to fill out are some what of an overkill generally speaking. But I do
believe that IF we could get all of the info we have on our forms filled
out from the doctors, it would satisfy everything Medicare could ever
want. It is just to much work to ask of the doctors. We probably need to
simplify what we are doing.
The following are the responses I received.
I write a plan of care and title it as such. I list each code and give
a description and its purpose, at the end of the plan of care I have a
line for the physician’s signature. I send a detailed Rx and the Plan
of Care with a cover letter to the physician asking him to sign a copy
and return while placing the other in his medical records. Even
medicare recognizes a plan of care as being legitimate. So far I have
not lost a case with a signed plan of care. The most it has taken is
one review with all of the proper documentation. They do not want you
showing up to a hearing on appeal with a signed plan of care that
perfectly matches the Rx. This would place them in a position of
stating the physician was wrong with his medical judgment. So far they
do not want to take on the M.D.s so when medicare starts shooting duck
behind the M.D.s.
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We bill Region B DMERC, and they, at this point, allow us to complete
all information on the RX/Letter of Medical Necessity except for the
doctor’s signature and the date it is signed. We fill everything else
out prior to sending to Dr’s office (with self-addressed stamped
envelope) for signature/date. Not sure what your DMERC might allow.
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I would love to see the form you are using. Sounds like a helpful tool.
Would you mind forwarding it to me?
(I am the office manager for our O & P Dept.)
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I can’t wait to hear what suggestions you come up with. This has been a
source of great frustration for our office as well. The docs rarely will
do more than sign our “suggested” Rx when we spell everything out to
them. I can’t believe what we are supposed to ask of them. No wonder we
can’t take care of our patients as well as years ago.
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Many of our clients use a “prescription request” form that our system
generates.It has the functional level selection, justification section,
list of Lcodes to be delivered, patient info, doctor name and info,
duration – basically all the required items. All this information is in
the system and tracked for it’s status in the WIP – work in progress so
your fab knows when to start building the job. There is no rekeying of
any information to produce this form since the system already has all
the information as part of the natural flow of information that begins
when the job is begun from scheduling and flows through
/evaluation/entering the job/tracking the job/ordering parts for the
job/billing the job.Some of our other clients just create their own
within our letter module without using our supplied format (though most
use the built in one).I have no idea what you might run for a system,
but if it has a competent letter module you may be able to create
something like this in your environment.You could even come up with a
template with a word processing once you come up with what repetitive
elements you want in the prescription request document. Some system’s
letter modules might get you a lot of the info you need and save some
re-keying at least.The key principle is, you are correct, if you don’t
do it for the doctor, you probably won’t get what you need for proper
billing documentation.Thus you need to create an efficient way of
supplying the doctor the information they need to “sign off” on.
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