Medicare is mandating that all DME suppliers become accredited in order to continue to become reimbursed by Medicare DME carriers for supplies given to Medicare recipients. Accreditation is the process in which an independent organization evaluates a healthcare provider and certifies that the healthcare provider meets certain quality standards.
There are several accreditation organizations including the oldest which is Joint Commission on Accreditation of Healthcare Organizations (or JCAHO). Their process includes an evaluation of the healthcare provider's clinical service as well as the provider's administration process, personnel management and information management.
This mandatory accreditation is due to the Medicare Prescription and Drug Improvement and Modernization Act of 2003. Some areas in the country had to meet a deadline in the spring of 2007 to be accredited, but ALL (but those exempt) providers will have to meet the September 30 deadline. Any DME supplier who provides equipment and services to Medicare beneficiaries will have to become accredited if they want to continue to be reimbursed by Medicare for their services.
Those except from this ruling are:
Suppliers providing drug and pharmaceuticals only
Physicians, including dentists
Prosthetists, including occularists
The accreditation process can take from 9 to 12 months. As we approach the deadline the demand on these accredting organizations will become greater and the process may take longer. Any provider needing to get accredited should decide which organization they want to go through and contact them as soon as possible.
The organization will inform them as to the process. Most likely they will review the current services, practices and policies to determine if they meet the standards. If the standards are not met, they will determine what changes need to be made and develop a plan for the provider including a time line for implementing the necessary changes.
Once this is complete, the provider submits an application for accreditation to the organization. The application can be submitted when the changes are being made. The accreditation organization will then review the application and any supporting documentation and determine whether the supplier is eligible for accreditation.
The cost of becoming accredited varies depending on the size and complexity of the provider applying. Prices include the cost of surveyor, travel expenses, hotel, etc. The best way to find out what it will cost is to contact one of the accredited organizations and ask for an estimate.
Copyright 2009 – Michele Redmond
Solutions Medical Billing