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May
11

A big part of the efficiency WorkFLOW delivers to your organization is realized through automating as much work as possible within each task or process. You can improve productivity even further by taking a step back and automating the actual creation of a WorkFLOW task.

There are several ways you can configure your software to generate a new task:

  • Data import from a 3rd party (e.g. from your billing software) or from a native program on your computer (such as Excel).

 

    • Saving a scanned document to a pre-configured bin, regardless of whether the document is indexed manually or auto-filed.

     

      • Email receipt to a defined email address. Any attachments will automatically be linked with the task and the email body will be captured in the task notes.

       

        • On a schedule or calendar basis based on a preset frequency.

         

          • ERN report generation from D&R Manager.

           

          If you need help setting up any of these kinds of task-creation automations, please reach out to Tech Support at support@medforcetech.com or [845] 426-0459 x2.

          Apr
          30

          We all know CMS makes you work hard for your money. There are many contributing factors that make getting the payment you deserve extremely challenging. But what is the most painful part and why? We turned this question out to you. We received 125 responses and the results were very interesting!

          When we asked what kind of communication was the most stressful, most respondents (53%) said Audits and requests for additional documentation (ADRs), but First Level Appeals came in second with 22%.

           

           

          Our second meaty question asked, “What is the toughest part about communicating with CMS?” Understanding the Requirements was the most popular choice at 34% of the answers. A total of 33% were challenged by the actual process, between finding the proper documentation, handling the logistics of submission, and meeting tight deadlines.

           

           

          What was most surprising to us was the high number of respondents who selected “Other” for questions number one and two (15% and 23% respectively). The vast majority of those who went outside of the preset options indicated that the most challenging part of dealing with CMS was their customer service. Several people noted that there can be confusing inconsistencies between CMS employees as well as changes to requirements or interpretation of policies without notification.

          Here are some representative responses we received to the request for more information upon selection of “Other”:

           

          • “One person at CMS telling us one thing. Calling back the same day and talking to another person on staff only to be told something entirely different! Seriously?”

           

          • “It is very difficult to get to a Level 2 for resolution to a denial.”

           

          • “We mail documentation and then get messages back that the FAX did not come through completely.”

           

          • “Dealing with people who don’t read what you send.”

           

          • “The people we talk to ‘read between the lines’; or sometimes seem to make rules up!”

           

          • “Lack of their own understanding between departments”

           

          It sounds to us like CMS could use some best practices, proper documentation and a sound workflow system to assist with escalations!

          Apr
          30

          Selecting a Process to Map

          Congratulations! You’ve decided to institute business process management. It’s an exciting and rewarding journey ahead. But that first step can be intimidating. Picking an appropriate first process to map is critical in building a foundation for success. It will be the process by which your staff is introduced to a new way of doing things, and where the first inklings of a return on your investment will be seen. In most cases, the first process to be mapped, standardized, and refined has a lot to prove. How do you choose the right one?

          One way to go about selecting the first process is to pick one you know really well. It makes sense that this can be a helpful way to learn your workflow automation software with a total focus on the technology and user interface. But it is highly likely that a process you are extremely familiar with has already been optimized. While automation will help you streamline and quicken the pace while ensuring nothing falls through the cracks, there are likely other processes that will deliver an even greater ROI and win over any internal skeptics.

          At MedFORCE, we recommend choosing a process you are currently troubled by as a starting point.

          There are several things to keep in mind when selecting one:

          • Opaqueness. Look for an area of your business you feel you have no control over or little insight into. At any given time you might not know what the status is with any tasks or how activities in the flow impact outcomes. Bringing this flow into the spotlight usually surfaces a lot of opportunities for standardization as well as highlighting the proper analytics for determining success

           

          • Falling metrics. Identify an area that used to hum along but now seems to struggle. There are many factors that could affect this including changes in regulations, requirements or staffing. In this case, it is likely there is an environmental factor that is influencing success. Breaking the process into the various parts and pieces can help you determine how to best adapt the process

           

          • Stagnation. Is there an area in your operations that plays a crucial role in your growth objectives, but you don’t see the improvement you need? The simple task of mapping a process can be eye opening. You will likely identify several steps that can be automated, freeing up your staff’s time and attention to focus on growth

           

          • Impact on profit. Find an area of your business where small changes in output can have a huge effect on your bottom line. These processes will deliver the fastest ROI for your workflow software.

           

          • Bottlenecks. If there is a particular spot in a process where things can easily get hung up, internally or externally, outlining each step will help you identify ways to eliminate or work around the bottleneck. It could mean you need to redirect staff’s focus, change employee responsibility, develop parallel work streams, or front-load work effort. The act of mapping the process can help you come up with new options for solutions.

           

          • Squeaky wheels. Most likely the processes that are at the biggest detriment to your mission are ones your employees already know about. Where people complain the most, there is usually a way to improve how the work is done.

          Regardless if it’s a troubled process or one you know well and clear, once you have targeted a process, we recommend ensuring you have a “bite sized” chunk to begin with. It’s always easier to start small and build from a platform of success. Layering on complexity ensures that each individual task or building block is perfected before adding more. It will also result in the greatest ROI and establish a strong business case to keep your team motivated. Starting your road to workflow automation with an easily-defined but challenging process builds the most solid, tested, and optimized foundation to build your lean operations.

          Apr
          10

          Welcome Tony!

          We are excited to announce Tony Russo has joined our team as a Senior Solution Consultant with a focus on major accounts and new markets. Tony brings nearly two decades of experience working with companies to select and implement game changing technology, especially in the Information Governance industry. He has worked with international corporations as well as professional organizations and government agencies to assist with addressing information governance related challenges including content management, retention, email archiving and supervision, and eDiscovery.

          Tony has previously held positions at MDY Advanced Technologies, CA Technologies, HP Autonomy, CVISION Technologies, and Covertix. We welcome his high energy, strategic thinking, and dedication to always find the right solution for our MedFORCE clients.

          Tony can be reached at arusso@medforcetech.com

          Mar
          25

          Tips & Tricks: Quick Copy

          It’s easy to gather all of the documents you need to respond to an Additional Documentation Request with MedFORCE Scan. Use our Quick Copy option to compile the individual pages you need to create a single PDF for submission.

          To Quick Copy:

          • Locate and view the document you’d like to copy
          • Place your cursor in the gray indexing area between the bins and the document, pointed at the desired destination bin. The cursor should turn into an arrow shape.
          • Right click and select “Copy Document” from the menu.
          • Indicate the number of pages to copy over and select OK.

          Here’s how we suggest using Quick Copy to help collect the support documentation to answer a CMS inquiry:

          1. Start by setting up a destination within MedFORCE Scan to assemble the needed copies. We recommend creating a bin within a Patient File Cabinet called “Audit.”
          2. Locate and Quick Copy individual documents into the Audit bin
          3. Reorder the pages to match the CMS request
          4. Print the entire bin/collection of documents as a single PDF

           

          Mar
          25

          CMS Audit Survey Results

          We were thrilled to see such a great response to our CMS Audits survey. We asked you to help us understand what volume of audits you face on a monthly basis. We received 125 responses with very interesting results that give insight into CMS Audits.

          Over half of respondents (58% total) receive 5 or fewer requests for additional documentation each month, but 14% – that’s 1 in 7 respondents! – must coordinate responses to over 20 requests per month.

           

          Our respondent demographics skewed toward DME/HME providers, with over 80% of the completed surveys coming from that area of the healthcare industry. DME/HME providers were well represented within each level of CMS request volume, with nearly even division across all categories.

          The non-DME/HME providers we heard from came from a range of areas including Home Health, Pharmacy (LTC, specialty, and retail), Orthotics & Prosthetics, Sleep Lab, Nursing Home/Rehab and one Hospital. With the exception of a single outlier, Pharmacy providers received under five CMS requests per month in 2014. This was not entirely surprising as the process for medication reimbursement is heavy on prior authorization, which can reduce auditing concerns later on.

          Only 12% of respondents currently use an esMD solution, while another 6% are actively pursuing engaging one. Over one third of respondents did not know what esMD was. This was the biggest surprise to us – and we urge all of you in this category to look into one, such as ZipMit, to dramatically ease the burden of CMS communications.

          The next survey will take a closer look at CMS communications and where the pain points exist. We hope you will take part. Follow this link and submit your responses before April 17th, 2015 to be included.

          Mar
          24

          5 Steps to Prepare for Audits

          There is a lot to manage when it comes to girding your organization to be CMS “denial-proof”. The preapproval and auditing process can be complex and demanding and requires focus. Being prepared to effectively handling an audit situation starts with the initial submission process and requires vigilance in both document and time management.

          All documentation dealing with Medicare is at risk of being audited, whether prepayment or post-payment. And the timeframe in which CMS can perform an audit is six years, requiring you to keep extensive archives. Once an audit is underway, you must adhere to strict deadlines for responses or risk its right to appeal.

          It should be recognized that these audits are not aimed at identifying actual fraud or abuse situations. The audit regimen for Medicare and Medicaid, in particular, has become focused on identifying technical deficiencies in supporting documentation and demanding refund of the payment. It’s a means to minimize spending, whether justified or not. You need to be aware of this and be prepared defend your payments. This is money that you have earned, and you shouldn’t let an administrative error keep you from getting it.

          This has become part of our mission at MedFORCE: helping clients succeed giving you the confidence that no critical activities or documentation will fall through the cracks.  Based on our deep experience in this area, we have come up with 5 steps to help ensure your organization is denial-proof.

           

          1. Deliver your product or service appropriately  - The first step to creating a denial-proof file is familiarity with the provider manual and all regulations that affect your service or product. This ensures you will provide the service or product in a way that guarantees you will be reimbursed. Control of expectations such as delivery dates, co-payments, and issues that directly affect the beneficiary is crucial to avoid complaints and reduce conflict with referral sources.
          2. Be familiar with the product-to-payment path  - It sounds simple, but knowing the steps needed to get from providing the product or service to payment is essential. Before you take action, you need to know what actions to take and how to do them correctly. This includes knowing what documentation is required to support each step. A line of sight from start to finish will make sure you stay on track.
          3. Create a consistent process  - Eliminate potential human error, identify and remove bottlenecks, and minimize the risk associated with employee absence by having a standard process in place for everyone to follow. A well-planned process saves time and effort by gathering and organizing what is needed at the time of service, rather than having to backfill later.
          4. Train your employees  - All personnel should understand the process and all requirements. They need to be closely reviewing documents for accuracy and pay particular attention to areas/issues that may have caused problems in the past. We even suggest taking training a step further and including adherence to process as a performance requirement for employee reviews. This not only highlights the strategic importance of a consistent workflow, it also aligns employee and organization incentives.
          5. Perform internal audits  - You should periodically review files for accuracy and completeness. A well-documented and implemented internal audit process will catch any errors or incomplete files before it reaches the demanding CMS audit phase.

           

          Technology can be an incredibly powerful tool in standardizing and automating your systems and helping you tackle all five of these important precautions. Without it, traditional offices can be forced to invest many man-hours in finding, copying and preparing documentations for audits. Misfiling or variances in how employees complete vital steps can be costly. And then there is the added challenge of tracking audit results and following up.

          Due to the large quantity of often-changing rules, having a central workflow that requires users to follow the correct steps for each product line or service is the best way to ensure the needed documentation will be on file to support payment in an audit. A solid software program will also enable the automation of specified steps, reducing opportunities human error. Electronic filing enables quick and easy retrieval of any documentation in question, while an esMD portal can save time and headache with the actual submission process. At the management level, analytics dashboards and admin controls allow you to get a real-time read on the efficacy of your operations and identify opportunities to mitigate risk.

          We urge everyone to make sure you have the proper processes in place to understand requirements, meet expected deadlines, retain specified documentation, and maintain a proactive stance in ensuring workflows are running smoothly. Don’t wait until the heightened state of an audit to understand how well your operations are functioning. Become denial-proof today.

          Feb
          25

          At the end of January, the Department of Health and Human Services (HHS) announced it set a goal that by 2016, 85% of provider payments under Medicare’s fee-for-service system will be based on the quality or value of care rather than the volume. In that same time frame, the agency hopes to be making 30% of its payments through alternative payment models like Accountable Care Organizations (ACOs), where care providers work together toward better long term outcomes for patients. [Source: HHS http://www.hhs.gov/news/press/2015pres/01/20150126a.html]. Enabling better patient outcomes, decreasing or sharing costs among providers, mutual participation in shared savings, and ensuring the wisest allocation of Medicare dollars are among the oft-cited benefits of these programs and goals.

          But along with the clear vision for value based healthcare, there remains the question of how the transformation will take place. One of the biggest questions in our mind is: How will new protocols for requesting, supporting and fulfilling quality-based payments impact the operational processes of providers? As pioneering ACOs and other value-based care providers (re)organize their systems to manage the care of patients, the implications of these new standards on the back office has yet to fully be explored.

          What will it mean from a practical standpoint for providers? How will the billing and reimbursement process change? How will the revenue cycle be affected in both the short term and long term? What kind of new documentation standards will be created? How will this affect audits and appeals? Where do integral members of the continuum of care that may not be physician based (e.g. Pharmacies and DME and HME providers) fit into the picture?

          The quality-based reimbursement requirements will be new to many and likely to be stringent, necessitating changes to internal processes for providers to secure payment. The documentation rules are going to change, as proof-of-value goes beyond proof-of-service. Will there be a need to document what didn’t happen (e.g. no hospital readmission) as well as what did? And, if so, how long could that delay payment from the time of service, and how will audit requirements change in multi-provider settings?

          A lot remains unknown and will only be unraveled with time. There are, however, clear truths that we know will remain the same:

          • Technology remains crucial to success. These payment goals will only be attainable through the integration of people, processes and data. Providers must embrace technology to allow for seamless care coordination, sharing of information, and integrated reporting.  Technology is the enabler that will allow the full benefits of value-based care to succeed.
          • Accessibility is vital. Flexible, adaptable and customizable electronic file and document management will continue to be a critical underpinning of successful operations. It seems reasonable to assume that documentation efforts will increase from both volume and need for coordination. Easy accessibility – with minimal clicks  - to your files and also your partners’ will be key.
          • Access rights management will become more important. As documentation and contractual requirements increase, the reimbursement process has the potential to become more complex. To streamline processes and eliminate clutter for your administrative and billing staff (as well as maintain appropriate information privacy) a robust access rights management system is necessary.
          • Standardization will rise in importance within individual providers as well as within networks. Business process management and workflow software can ease the burden of coordinating delivery of care in addition to any/all aspects of running your organization, including Intake, HR, Billing, Claims management, and more. Once a process is standardized, part or all of it can be automated, keeping complex processes on time and on task.
          • Integrations will be obligatory. All-in-one will cease to be an effective way to manage, as various providers will need to bring together individual systems effortlessly. Easy and standard integration with a myriad of other healthcare related software will be the norm, including various billing programs, practice management, EHR, document imaging, and delivery verification.  Software that can easily adapt, interface, integrate and customize will be the technology of choice.

           

          What are your questions and concerns regarding the shift to Medicare payments based on quality of care? What are you doing now to ready your organization for these changes? Leave us a comment and let us know what you’re thinking.

           

          Feb
          25

          Did you know that you can connect almost any software directly to your MedFORCE files? Whether it’s your billing program, Excel, Word or any other 3rd party software, our External Link Tool buttons can be configured to effortlessly open or create a patient file within MedFORCE Scan. Get instant access to all of the documentation and information you need, regardless of the software you use.

          The External Link Tool is a standard feature in MedFORCE Scan.

          • Instantly view or create patient files
          • Implement in almost any software you use
          • Create unlimited number of buttons within 3rd party applications
          • Customize buttons to link to specific patients and fields within your documents
          • Name your buttons with meaningful terminology
          • Options for static or dynamic buttons, depending on where the pertinent information appears in the 3rd party program

          Contact our Support Team at support@medforcetch.com or [845] 426-0459 x2 and we’ll be happy to help you set it up.

          To design and create buttons yourself, follow these steps:

          • Open the program you’d like to connect directly with your documents
          • Right click on the External Link Tool in your system tray and select “Show Form”
          • Follow the step-by-step instructions to create, customize and publish your button.

          Although it is a simple process to set up a button, we typically recommend Administrators create them for consistency and efficiency. For Install clients, the buttons should be configured on each work station. For Hosted/SaaS clients the buttons can be configured centrally to appear for all users.

          As always, if you have any questions or need any help, please do not hesitate to reach out to our Support Team. We will be happy to help you implement a custom linking button or can organize an online training on this tool with the implementation team. You can reach our support team at [845]426-0459 x2 or by emailing support@medforcetech.com.

           

          Mar
          07

          Chestnut Ridge, NY – March 6, 2013 – MedFORCE Technologies, Inc., a leader in document management and business process software solutions, today announced that they have obtained certification as a Health Information Handler (HIH). MedFORCE has undergone and completed extensive testing with the Centers for Medicare and Medicaid Services (CMS) as part of the Electronic Submission of Medical Documentation (esMD) Program from CMS. MedFORCE is now approved and successfully submitting medical documentation via the esMD program.

          According to estimates made by CMS, Medicare programs issue billions of dollars per year in improper payments. Medicare conducts pre and post payment audits routinely to determine the appropriate payment and / or recoupment amount. CMS employs several types of Review Contractors to measure, prevent and correct these improper payments. In addition, CMS has recently approved a program to enable prior approval of some items thereby, ensuring that the appropriate documentation is on file and the patient qualifies for the product prior to the product being provided / billed. In order to conduct an audit or provide a prior approval, the contractors must review all of the documentation that proves the medical necessity of the item. Until recently there were only two ways to get that information to the contractors, mail paper records or fax them. Providers had no way to receive confirmation that the documentation was received timely and in its entirety. CMS introduced esMD (Electronic Submission of Medical Documentation) to enable secure and timely electronic submission of the documentation. CMS intends to expand this program in the future to include any submission of documentation, not just audits or prior authorizations.

          MedFORCE is currently offering their solution to electronically submit medical record documentation and Prior Auth requests for PMD directly through their secure infrastructure. As an HIH MedFORCE is one of a few organizations that can submit documentation to CMS directly. That means there is no additional party handling your sensitive healthcare information, and you will be dealing with MedFORCE support staff directly. Tracking of the submission dates and collection of documentation required can be streamlined, submissions and status updates can be received live. Using MedFORCE will allow you to setup alerts when a submission is due, and route the case through your organization electronically. “This flows naturally into our development of process management solutions for our customers” said Esther Apter, CEO of MedFORCE Technologies. “Preparing documentation for an audit is time consuming and ensuring that the right documentation is submitted timely is critical. A missed or insufficient audit can cost a company their business”. MedFORCE esMD solution provides a tool that will ensure collection of the documents is done accurately, monitoring to validate that the documents were submitted timely and the ability to conduct an electronic review of what is going to be submitted.

          Stop wasting time and money faxing, emailing and mailing your responses to documentation requests and Prior Authorization requests. To find out how you can cut costs, streamline your process and submit your documentation electronically, contact us!

          About MedFORCE Technologies, Inc.
          MedFORCE Technologies is a leading provider of document management and workflow solutions within the Healthcare industry. They specialize in reducing cost, increasing productivity and improving cash flow. Collaborating with its sister Healthcare Management Solutions Inc., (HMS) a medical billing service company. HMS’ innovative technology has made it an established name in the healthcare industry since 1993. MedFORCE was established in 2002 to provide paperless solutions that were first implemented at HMS. Their expansion into business process management solutions has further enhanced their already stellar reputation. For more information, visit www.medforcetech.com, e-mail info@medforcetech.com, or call 1-866-237-1190.

          Contact:
          MedFORCE Technologies
          Eric Jacobs
          ejacobs@medforcetech.com | 1-866-237-1190 x131

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