Accreditation—a word that can strike fear into the hearts of many HME owners. The weeks leading up to an audit can be stressful for dealers, as they need to ensure that all paperwork is accounted for, processes are aligned and there are no major gaps the company is missing. It’s an all-hands-on-deck situation, but one that can be less daunting if the organization has some helpful processes and solutions in place beforehand. HomeCare sat down with Aimee Swope, customer success manager at Apacheta, to learn some best practices and tips for ensuring the delivery process of an organization is buttoned up before an audit.
Q: What is the No. 1 pain point in the delivery process that causes HME dealers to become stressed before an audit?
SWOPE: The main reason for stress is the potential of missing delivery documentation. There is a lot of pressure to ensure technicians have the correct forms for each piece of equipment they are delivering throughout the day. Especially when they are delivering multiple pieces of equipment to the same patient home, it can become a nuisance to double-check and ensure all forms for an oxygen setup and the forms necessary for a wheelchair are completed. Not to mention that when the patient or caregiver begins asking questions and needs to be trained on the equipment, technicians can easily get distracted and miss a form or two, or even a signature.
Q: How could this pain point be eliminated?
SWOPE: By moving away from a paper-based system. Paper forms can easily get lost, left in the truck or even be forgotten at the office, thus becoming unavailable to be filled out during a delivery. A system of checks and balances for the technician is needed. Once a delivery request is entered in the system, the software can pull all the forms needed for each piece of equipment in the order. Then, at delivery, it makes sure the technician completes each form before moving on to the next form, ensuring all the required information is captured. When the software runs through a digital checklist, it eliminates the potential for a technician to miss a form, requiring a repeat visit to the patient’s home for paperwork, which is lost productivity time for the technician.
Q: Besides eliminating the potential for missing forms, what else does an electronic system offer?
SWOPE: Another critical component for HME companies to keep track of are the serial and lot numbers for every single piece of equipment. In the event that an item is recalled, organizations need to quickly be able to view which patients have that specific item so it can easily be replaced. Electronically capturing these numbers at the time of delivery provides a clear record of what items are with each patient. With an electronic solution, bar codes can be scanned at the time of delivery, ensuring the integrity of this information.
Additionally, many auditors will want to test an organization’s patient records system by searching via order identification numbers. By electronically capturing signatures and serial numbers associated with an order in the field, the software will automatically sync delivery information with the back-office system that is used to maintain customer orders and patient records. This eliminates the potential error of an employee typing incorrect information into the system. It also ensures all patient paperwork for each of the orders is grouped so the auditor can easily follow the electronic paper trail.
Q: What happens when forms change?
SWOPE: A major benefit of using an electronic system is administrators can customize in the software what forms need to be completed for each piece of equipment so the checklists accommodate changing compliance and Medicare standards. This also eliminates the need to print out a stack of newly-required forms each time the government updates the paperwork. With a quick upload to the system, the technicians now have the latest versions of all documentation needed for compliance.
Q: Can a signature still be missed, even when one is using a digital platform?
SWOPE: Unfortunately, yes, it is still possible to miss a signature when each form must be signed separately. However, by using a digital solution with an integrated system of checks and balances, there is no worry about losing or missing a signature. Using a mobile device such as a tablet rather than hard copies allows a technician to review each form with the patient or caregiver and then capture the signature once, which significantly simplifies the paperwork process.
Q: What else do auditors look at in the delivery process?
SWOPE: Safety is a top concern for auditors, and therefore the pre-trip inspections are something carefully looked at as well. A company can easily get fined on an audit for failing to report daily on safety checks. Whether capturing the checks on paper or electronically, it is critical to ensure all vehicles are checked for mechanical functionality, cleanliness and first-aid kits with unexpired items, and that all equipment is stored safely in the vehicles in the event of an accident.
The great thing about using an electronic delivery logistics system is that the pre-trip inspection and odometer reading can be added as a mandatory first step before the technician begins the route for the day. It can also be customized pending what the company wants to include during the inspection. For example, some want to measure not just the braking system, engine, air conditioning and windows, but they also want to measure the fluid amounts in the vehicle daily. Regardless of the inspection list, by guaranteeing it is done every day, HME owners can have peace of mind knowing documenting this information every time is another way of being ready for an audit.
Q: Anything else the auditor looks for?
SWOPE: Record retention is another main point auditors will look for during their visits. As opposed to reviewing recent delivery orders, they can also request to see a record from six months ago and will scrutinize it closely, looking all the way down to the lot numbers and matching the dates. With an electronic record system, companies can worry less about losing a patient file or a trail of paperwork in a file cabinet. Having a system that automatically syncs between delivery software to the back-office management system ensures there are no forms, signatures or information missing on any records.
In fact, confirming a 100 percent elimination of lost delivery and pickup or exchange tickets can bring peace of mind in knowing nothing is missing when it is time for an audit. And as we know, without proof of delivery, the company cannot bill insurance and get paid for the service, which leads to a loss of revenue. The benefits of using an electronic system are significant beyond accreditation matters, as the system ensures the business continues to bring in revenue. Audits put many parts into motion, just one of them being the delivery process. Having an electronic delivery system in place time allows HMEs to focus on other operations within the business.