decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
DME Model Compliance Plan / Compliance tips and tools / Effective DME compliance on a shoestring
Subscribe or sign in to view the full article.
Article Overview
This article discusses a low-cost approach to building and improving a durable medical equipment compliance program using guidance from the Office of Inspector General. It covers broad compliance program elements, risk-area review, internal policies and training, auditing and monitoring, documentation practices, and refund and quality-improvement processes. The material is intended for DME suppliers, compliance staff, managers, and others responsible for reducing billing and documentation risk.
Why This Topic Matters
DME suppliers operate in a heavily scrutinized area where documentation, billing, and refund practices can create significant exposure. This article helps readers understand the main compliance themes that organizations should evaluate when designing a practical program.
Article Sections
-
Overview of the compliance program approach
Introduces the purpose of the compliance guidance and the article’s general approach to building a practical program. It also frames the role of standards of conduct and organized planning.
-
Risk areas and priority framework
Explains how the article organizes compliance risk areas into higher- and lower-priority groups. It discusses the use of policies, training, and monitoring as core elements of a staged compliance effort.
-
Top 15 risk areas
Summarizes the major compliance risk categories highlighted by the author for closer review. The section focuses on common DME operational and documentation problem areas that should be evaluated in a compliance program.
-
Capped rentals and modifier tracking
Addresses a specific rental compliance topic and the need for tracking and documentation in the rental cycle. It also notes related administrative checks used in auditing.
-
Documentation, refunds, and ongoing monitoring
Covers the importance of maintaining support in the record, handling overpayments appropriately, and continuing oversight through auditing and management reporting. It closes with the role of quality improvement in reducing risk over time.
What You Will Learn
- How a DME compliance program can be organized with limited resources
- How risk areas are prioritized in a practical compliance plan
- What broad operational and documentation areas are commonly reviewed in DME compliance
- How internal policies, training, auditing, and monitoring fit together
- How quality improvement methods support ongoing compliance efforts
Who Should Read This
- Durable medical equipment suppliers
- Compliance officers and auditors
- Billing and reimbursement staff
- Practice managers and administrators
- Healthcare operations leaders
Modifiers Discussed
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com