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Pilot Overview
EMDI Topline Healthcare conducted a successful pilot for CMS on power mobility. They created an end-to-end solution that proved interoperability of multiple systems. Their system included AEM from Adobe Systems, Cloverleaf from Infor and implementation of our software, Codeable Language™. Topline Healthcare assembled a team of physicians, nurses, physical therapists, DME providers and leading healthcare systems companies.
Pilot Goals
- Reduce the error rate of submissions.
- Improve the overall patient experience.
- Improve the process for the providers.
- Simplify the process.Automate the process.
Prior to the start of the program, Topline Healthcare discussed with providers the issues they were facing in order to determine their biggest obstacles when attempting to submit a Prior Auth or order for Power Mobility DME. Of more than 40 providers polled, we found they had three major concerns:
- Finding the needed forms.
- Knowing which forms to use.
- Understanding the needed information to support the request for DME.
With this information, Topline Healthcare began our pilot by creating an order sets that allowed the provider to fill out all of the required forms, at the time of the order, using AEM forms (Adobe Systems). Codeable Language™ (Topline Healthcare) was used with the EMR system to improve the providers' documentation and to support the medical necessity. The claims were submitted via Cloverleaf (Infor) to the MAC and RACs for approval. We used a checklist for the provider to follow in order to ensure the completeness of the submittal. We also used a nurse reviewer to double check the package prior to submittal for prior auth to ensure that dates, times, signatures and all were completed fully.
Using the order set, the providers had all of the needed forms in a digital format in one location, which reduced the risk of omission errors. This also allowed the information to be submitted electronically from the EMR to the DME providers. The DME providers could then fill in the needed information about the device specifics and home evaluation, and then return it to the provider to complete the orders.
Codeable Language™ was used to allow the provider to submit accurate and needed information about the clinical aspects of the patient needs. Cloverleaf was used due to its ability to receive information from several different EMR systems. This allowed us to have clean data for reporting.
The success of all this was supported with education to the providers at the beginning of the pilot. This education was completed in person, via Skype and in written forms.
Organization(s)
| Name: | POC: | Email: | Phone: | Website: |
| EMDI Topline Healthcare | Mark Kimmel | Mark.Kimmel@ToplineHealthcare.com Susan.hemme@ToplineHealthcare.com | 562-822-5559 949-644-2500 | http://www.toplinehealthcare.com/ |
Documents:
PMD Workflow Within EMR Related Links
Related Links |
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| HealthIT Proving Grounds: https://www.healthit.gov/techlab/ipg/node/4/submission/1346 |