Presentation is loading. Please wait.

Presentation is loading. Please wait.

TouchPointCare DME Performance Management. TouchPointCare was created to improve communication between healthcare providers and their patients…

Similar presentations

Presentation on theme: "TouchPointCare DME Performance Management. TouchPointCare was created to improve communication between healthcare providers and their patients…"— Presentation transcript:

1 TouchPointCare DME Performance Management

2 TouchPointCare was created to improve communication between healthcare providers and their patients…

3 TouchPointCare DME To prevent fraud and abuse and to ensure patient safety and quality care a DMEPOS Supplier’s Compliance Program should include regular and consistent contact with their patients to monitor and document continued use, proper functioning of, and need for, their equipment. “Undergoing an audit is not a particularly pleasant experience, but you can do a lot to make the process easier and increase the likelihood of a positive outcome. The number one rule: Keep comprehensive, detailed records. This cannot be emphasized too strongly.” Deborah Conn How to Survive a Medicare Audit O&P Almanac


5 Clarification regarding Beneficiary Use of CPAP The Continuous Positive Airway Pressure System (CPAP) policy addresses the issue of continued usage of the CPAP machine (E0601). When billing to the DME MAC for a monthly rental item it is the suppliers’ responsibility to ensure that the item provided continues to be used. The following are two separate requirements regarding the usage of CPAP; 1. A general monthly rental item requirement, and 2. Specific CPAP policy requirements regarding medical necessity beyond three months of covered therapy

6 The general Medicare expectation is that the suppliers will monitor usage of the rental equipment that is being billed. Therefore, it is the suppliers’ responsibility to monitor on a monthly basis whether the item provided to the beneficiary is still being used. The CPAP Policy states; “If there is discontinuation of usage of an E0601 device at any time, the supplier is expected to ascertain this, and stop billing for the equipment and related accessories and supplies.” With this statement in mind, it is expected that if the supplier is billing a monthly rental item to the Durable Medical Equipment Medicare Administrative Contractor (DME MAC) they are attesting knowledge of the beneficiary using the equipment. If the supplier does not monitor on a monthly basis when billing to the DME MAC for a monthly rental item, and it is found that the beneficiary has stopped using the rental item, it is expected that the supplier will submit a voluntary refund request. In the event of an audit, if found that the supplier has been billing for a monthly rental, and the beneficiary had stopped using the item, a demand letter for recoupment will be sent.

7 TouchPointCare Key Concepts: Provide healthcare organizations with customizable tools to improve ability to interact with their patients and collect information Focus on low cost strategies, simple enough for patients, sophisticated enough for providers Utilize subcription revenue model and create win/win proposition with providers

8 TouchPointCare is designed to document contact with your customers and record any change in status related to their use of prescribed equipment thereby facilitating Medicare compliance requirements. “In summary, we are very pleased with the partnership we have developed with TouchPointCare to date. Their system provides a very cost effective telehealth solution for the company…in any given month, we estimate that TouchPointCare will handle up to 5,000 phone calls on our behalf. John Kolar Advocate Home Care Products

9 TPC Performance Management Issues: Prevent Fraud and Abuse Improve compliance to yield better outcomes Document improved patient outcomes Collect data for value studies Address adverse event issues Improve patient data accuracy (and billing success) Address patient notification issues Identify and manage patient complaints Address patient safety concerns Conduct Patient Satisfaction surveys

10 Additional & Customizable Questions can address: Patient Safety Oxygen Storage Smoke Detectors and Fire exit strategies Recent hospitalization Satisfaction Other clinical issues

11 TPC Features allow you to: Create branching logic within question series Set response thresholds that will trigger alerts based on certain responses and sent immediate emails Manage the call center function, so agents knows what to do in every situation, (allowing non-clinical or non-expert people to make calls) Identify and set the number of attempted calls you want to make to each patient Trigger email alerts if unable to connect with a patient after multiple attempts, (or bad patient data, or uncooperative patients) Provide multiple reports to manage all of the above and display all of the data collected, using both Crystal and ChartFX reporting tools for a very robust reporting function

12 TouchPointCare DME Reports Set desired date ranges Build custom reports; by group or individual patients to display responses Choose to display all data or only “exceptions” or triggered “alerts” Manage all aspects of the program

13 The TouchPointCare DME Advantage Meet Medicare Client Compliance Requirements National Patient Safety Goals Variance report data keeps billing information accurate and up to date Medicare audit data is available on-line, 24/7 All data is gathered and stored on secure, HIPPA compliant, servers with full back-up and recovery TouchPointCare DME pricing is “per completed call” with unlimited reporting and analysis You make the calls, or ask TouchPointCare to do so… You decide the call frequency per customer and manage your monthly costs

14 Technology Issues for TouchPointCare: Hosting eliminates many IT hassles Available 24/7 Secure Server Robust security Daily back-ups HIPAA compliant ASP.Net SQL Server Crystal & ChartFX Reporting


























40 David Anderson, Ph.D., FACHE CEO TouchPointCare 866-713-6590

Download ppt "TouchPointCare DME Performance Management. TouchPointCare was created to improve communication between healthcare providers and their patients…"

Similar presentations

Ads by Google