CERTIFICATE OF MEDICAL NECESSITY

Director of Finance and Accounts Receivable Manager

Home Medical Equipment Companies continue to experience difficulties in getting CMN’s filled out correctly by the Physician or their staff resulting in accounts being put on billing holds.  In most cases this is applicable to Medicare claims but is also true for some Medicaid and Commercial claims.  Depending on the size of the company, the numbers for held billing could be staggering, from several hundred thousand to several million dollars.  Our CMN Recovery service resolves this problem for our clients.

Most physicians do not like to fill out CMN’s and do it grudgingly often resulting in incorrect information on the CMN or just simply return an incomplete CMN.  This requires that the CMN be sent back to the physician to be filled out again and returned.  Often the physician will say he or she has already filled out the CMN once and does not want to do it again.

Our Affiliate / Our Affiliate offers a service for the home medical equipment industry called  “CMN - Document Completion, Delivery, and Follow-up”. As you must know, getting “Section B” of the CMN filled out correctly is very inconsistent at best and if not filled out correctly, will hold up claim processing, resulting in increased A/R. 

Our program under Medicare law (as a outside party) allows our medical professionals (RN’s) to fill out “Section B” correctly, and then send it on to the Physician for verification and signature.  Our program is designed to process CMN's from A to Z, including the completion of "Section B".  A few of our customers have chosen to customize our service to fit their CMN processing needs. For example, a simple two-step program: 1.) You can utilize our service to guarantee the delivery of accurate CMN's to the Physician.  2.) Our follow-up program will then monitor and expedite the return of a compliant CMN from the physician.
 
In any form you choose to use our service, our diligence in making sure that the CMN goes out correctly guarantees accuracy, completeness, and efficiency thus eliminating incorrect CMN’s as a reason for holding up claims processing.  This is a great program for the Home Medical Equipment industry.

How Our Process Works:

Document Review & Completion Prior to Delivery.

• Our medical clinicians (RN’s) will complete all of “Section B” correctly, based solely on the information provided by the ordering Physician and related testing a required by the carrier.

• This information shall be in the form of any or all of the following but not limited to: intake sheets; clinical lab reports; sleep studies; Physician’s prescription or any other documentation that supports the completion of the CMN.  

  Mailing and Retuning of CMN's.

• After the CMN has been reviewed for completion, each CMN will be mailed to the Physician with a cover letter asking the Physician to sign and date the CMN and return in the self-addressed, stamped envelope provided.

• The Physician will send the completed CMN back to Our Affiliate. Our Affiliate will forward only accurate, compliant CMN's back to the client.

  CMN Follow-up.

• Inaccurate CMN's will be resent to the Physician with a cover letter indicating what is incomplete and how to correct.

• Our Affiliate will resend any CMN's still outstanding after 20 business days with a specific cover letter indicating a sense of urgency.

• After 30 business days we will send another letter and also contact the Physician by phone. (Rarely does the follow-up process get to this point)

Monitoring Reports

• Status tracking report – This report will track CMN and Verbal Orders through the working process of perfecting for delivery to the Physician.

• Inaccurate Returned report  - This report will list all CMN’s and Verbal Orders that have come back with   errors.  From this report we will generate a trend analysis report of errors that have a consistency of re-occurrence.

• Accurate Returned report – This report will list only accurately returned CMN’s and Verbal Orders.

If you are interested in this service, then simply call us today for more information at 330.332.3115

Thank you for your time and consideration.

 
Linda Bungard
Our Affiliate Member