In accordance with the Patient Protection and Affordable Care Act, all patients needing Medicare reimbursed home health services are required to have a documented face-to-face encounter with a physician or nurse practitioner within 90 days prior to the start of home healthcare or within the first 30 days after start of service. This documentation is required in addition to completing and signing a Centers for Medicare & Medicaid Services (CMS) Form 485 (also known as the Home Health Certification Plan of Care), which is currently used by home health agencies to certify a patient's need for services. For hospices, a face-to-face encounter must be made by a physician or nurse practitioner with a Medicare beneficiary enrolled in hospice care before their 180-day recertification and for each 60
th day of recertification period after that date
The purpose of these CMS face-to-face mandates is to achieve greater accountability when verifying a patient's eligibility for home health services or re-certifying the need for continued hospice care, and that it be based on current knowledge of the patient's condition. However, over the past several months, we have been talking with our home health providers and hospice customers about the challenges associated with Medicare's new face-to-face requirements. They have told us these requirements can be an onerous process, delaying patient care and impacting the way they do business. Many providers are also concerned about setting up the resources required to comply on already-stretched budgets. Fortunately, there is technology that can help home health agencies and hospices comply with these new mandates by enabling them to send patient documentation electronically to a physician in minutes instead of hours or days.
IVANS eFormManager, the latest HIPAA-compliant solution to be offered under IVANS LIME™ Healthcare Information Exchange (HIE) platform, is an electronic signature application that helps providers gain approvals faster and facilitates Medicare reimbursements by eliminating manual processes and automating the administrative workflow. Our solution replaces the time-consuming task of mailing in or faxing a CMS Form 485 and face-to-face documentation, and also can be used with other patient documents including death certificates, referrals, doctor's orders and supplemental orders.
Using eFormManager, the home health or hospice creates a CMS Form 485 and/or a face-to-face document either manually (e.g., scanning in the form) or electronically (e.g., via an EMR or form builder). The provider then attaches the document, indicating where a signature is required and securely sends the file to the physician via email. Upon receiving the document, the physician electronically inserts his signature and then emails the file back to the home care agency or hospice. Alternatively, the physician can print out the CMS Form 485 and/or face-to-face document, sign his name manually and fax it back to the provider. In both instances, the patient care documentation is captured and tracked automatically via IVANS eFormManager.
To further streamline the administrative workflow, providers can archive the files for up to 90 days as well as monitor face-to-face and Form 485 documentation in various stages of review. And, if the document is not signed within three days, IVANS eFormManager can automatically re-send the file, greatly reducing time and money spent on following up these documents.
We understand that complying with face-to-face and CMS Form 485 requirements can be burdensome, duplicative and impractical, especially for those caring for patients in rural areas where there is a shortage of physicians. However, by using IVANS eFormManager, home health and hospice providers now have a secure, seamless and electronic way to get the authorization needed for patient care while ensuring they are in compliance.
For more information about IVANS eFormManager, click here.
Michael Schramm is the vice president of product and innovation for IVANS healthcare business unit.