Incomplete documentation: A well-known risk in DME ordering
Complete documentation for DME orders is critical for getting needed equipment and supplies to patients through their health benefits, but putting together all the required information is difficult. Parachute Health has spent six years listening to the most qualified experts we could find: the providers and suppliers who know healthcare inside out and are sick and tired of endless paperwork and long delays that block patients' access to care. We’ve also looked closely at payer requirements across Medicare, Medicaid, and private health plans. We built the Parachute Platform with all these needs and requirements in mind to address documentation pain points, so that clean and complete orders are submitted every time, with all the information needed to fill them.
Virtually everyone with experience ordering DME knows that incorrect documentation is a big challenge when it comes to DME orders. Providers and suppliers dread the endless paperwork required to meet diverse documentation requirements for different product categories across many payers. Also, reports from the Center for Medicare and Medicaid Services and the US Department of Health and Human Services show that insufficient documentation is the leading cause of improper payments.
In 2021, improper payments accounted for more than 25 billion dollars in Medicare Fee-for-Service (FFS) funds that did not meet program requirements. Of that huge figure, 64 percent was due to insufficient documentation across all CMS claim types. For Part A and B claims, medical necessity and incorrect coding contributed substantially. For DME claims, not only was insufficient documentation the cause of most red flags, the improper payment rate was around 29 percent compared to a 6 percent average across claim types, and that's cause for concern.
Improper payment in the DME category has also been more difficult to address: data collected from 2014 to 2021 shows that overall, improper payment rates are improving. In fact, this is the fifth consecutive year the Medicare Fee for Service (FFS) improper payment rate has been below the 10 percent compliance threshold established in the Payment Integrity Information Act of 2019. But when it comes to DME claims, the CMS review found that improper payments actually increased compared to the previous year.
Where improper payments are a problem, audits can be quick to follow. Providers and suppliers got a respite from audits due to COVID-related staffing shortages and CMS’ subsequent decision to suspend calling operations for a few months in 2020, but that was just a temporary break.
Where improper payments are a problem, audits can be quick to follow.... Better order technology that enables transparency and supports complete documentation is one clear path to fixing issues with the DME category.
Better order technology that enables transparency and supports complete documentation is one clear path to fixing issues with the DME category. Parachute Health’s best-in-class DME ePrescribing platform was designed to facilitate creation of clean, complete orders with a focus on automated documentation checks. The result is an order acceptance rate over 99 percent on the Parachute Platform, with all required documentation sent to the suppliers.
A switch to Parachute Health can not only spare exhausted healthcare workers by handling the complexities of DME ordering so they can refocus on patient care, it can also ensure that incomplete documentation won’t be an issue that triggers future CMS audits.
Experience the peace of mind that comes with confidently sending clean orders that are filled quickly. With Parachute Health’s delightfully simple DME ePrescribing, you can prioritize patient care over paperwork—without the risk of getting tangled in red tape.
Healthcare providers: Try delightfully simple DME ordering today.
Suppliers: Learn how Parachute Health can help modernize your patient intake.
Health plans: Gain network insight with a free, customized Scorecard by Parachute.
