website templates

MHM compliance tracking

PAP setup - example 1/10/19

Instruction

1. Pt is instructed on use and care of device and suppies.
2. An explanation of compliance requirements and a hand-out is given identifying the usage and follow up dates required by the insurance company.  

Patient is followed continuiously via U-Sleep


All patients (Resmed)

All patients are followed via U-Sleep. If a patient misses the 4 hr per night goal a message is sent to the patient via (text, call, or email).

When pt meets CMS usage compliance - example (1/31/19)


As early as day 21
or when the patient meets usage compliance before day 60 post setup


A notification is sent to the compliance specialest. The specialest als moniters Airview and Encore.

A call is made to the patient within 3 working days.

Hi [PATIENT NAME]. This is Sherrie calling from Mitchell Home Medical about the cpap we set you up with on [SET UP DATE].
I am calling to congratulate you! I looked at the data and see that you have met the usage requirements for compliance.
I want to let you know that to qualify for continued use beyond the first 90 days, the next step required by your insurance is to have a follow-up appointment, ideally with your sleep physician, [PHYSICIAN 1 NAME] and [phone number]. The appointment needs to occur between [Min and max FOLLOW UP DATE].

It is also very important to let me know the date of that appointment as soon as possible.

Please call me back at 734/234-8114. If you get my voicemail just leave your name and date of your scheduled visit.

Thanks for using Mitchell Home Medical.      


   


      


Follow up requests

F2F notes request

1. If we know the visit date: notes are requested for visits. These requests are made 3-5 days post office visit.
2. Notes are requested where we do not know a visit date and the setup date is beyond 60 days in the past.
3. All requests are marked in custom fields at sales order level in Brightree.

After a total of three recuests to pt for follow up and three requests for notes from the Dr's office, the patint is considered to have failed compliance:
The patirnt is notified that he/she has failed compliance and needs to

a) return the device

b) purchase the device

c) request a second triall by contacting their Dr.

and billing (Jaime) is notifed.

Patients not meeting usage compliance

Patients are monitered at approximatly day 45

Airview/Encore information is assed and between days 45 and 60, if the patient has not met usage compliance and is above 45% we call to assess the issue.

Mobirise