Brad E Dicianno1,2,3, Madalyn Gottschalk4, Elizabeth Benton2, Mark Caro4, David Pajer4. 1. Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States. 2. UPMC (University of Pittsburgh Medical Center) Center for Assistive Technology, Pittsburgh, Pennsylvania, United States. 3. Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, United States. 4. Enterprise Data Integration, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States.
Abstract
OBJECTIVES: Power mobility devices (PMDs) such as power wheelchairs and scooters are crucial for mobility, self-care, employment, and leisure activities. The documentation process for insurance coverage is complex and requires communication and document delivery among multiple stakeholders. The objective of this project was to develop an electronic submission process for medical documentation of PMDs submitted for prior authorization to a Medicare Administrative Contractor (MAC) and implement a standardized means of communication between providers and payers. METHODS: A protocol was developed to create and securely transmit an electronic prescription and several documents that outline medical necessity from a clinical team using EpicCare to a MAC via a Health Information Handler. A Rehabilitation Technology Supplier (RTS) added detailed product information and specifications to the electronic package during transmission. SETTING: The setting involved in the study was University-based outpatient assistive technology clinic. RESULTS: The protocol demonstrated successful transmission of an order, medical documentation, and request for signature. Results were transcribed to a readable format for the clinical team and RTS. A set of quality metrics for use in future projects was also identified. CONCLUSION: This pilot project demonstrated successful electronic exchange and transmission of medical documentation for durable medical equipment from the electronic health record to a MAC. Thieme. All rights reserved.
OBJECTIVES: Power mobility devices (PMDs) such as power wheelchairs and scooters are crucial for mobility, self-care, employment, and leisure activities. The documentation process for insurance coverage is complex and requires communication and document delivery among multiple stakeholders. The objective of this project was to develop an electronic submission process for medical documentation of PMDs submitted for prior authorization to a Medicare Administrative Contractor (MAC) and implement a standardized means of communication between providers and payers. METHODS: A protocol was developed to create and securely transmit an electronic prescription and several documents that outline medical necessity from a clinical team using EpicCare to a MAC via a Health Information Handler. A Rehabilitation Technology Supplier (RTS) added detailed product information and specifications to the electronic package during transmission. SETTING: The setting involved in the study was University-based outpatient assistive technology clinic. RESULTS: The protocol demonstrated successful transmission of an order, medical documentation, and request for signature. Results were transcribed to a readable format for the clinical team and RTS. A set of quality metrics for use in future projects was also identified. CONCLUSION: This pilot project demonstrated successful electronic exchange and transmission of medical documentation for durable medical equipment from the electronic health record to a MAC. Thieme. All rights reserved.
Authors: Karen Fung; Taavy Miller; Paula W Rushton; Mary Goldberg; Maria L Toro; Nicky Seymour; Jonathan Pearlman Journal: Disabil Rehabil Assist Technol Date: 2019-04-23
Authors: Karen H Fung; Paula W Rushton; Rachel Gartz; Mary Goldberg; Maria L Toro; Nicky Seymour; Jonathan Pearlman Journal: Afr J Disabil Date: 2017-09-08