TouchPointCare for DME

DME Performance Management
TouchPointCare was created to
improve communication between
healthcare providers and their
TouchPointCare DME
To prevent fraud and abuse and to ensure patient
safety and quality care a DMEPOS Supplier’s
Compliance Program should include regular and
consistent contact with their patients to monitor
and document continued use, proper functioning
of, and need for, their equipment.
“Undergoing an audit is not a particularly pleasant
experience, but you can do a lot to make the process easier
and increase the likelihood of a positive outcome.
The number one rule: Keep comprehensive, detailed records.
This cannot be emphasized too strongly.”
Deborah Conn
How to Survive a Medicare Audit
O&P Almanac
Clarification regarding Beneficiary Use of CPAP
The Continuous Positive Airway Pressure System (CPAP)
policy addresses the issue of continued usage of the
CPAP machine (E0601). When billing to the DME MAC
for a monthly rental item it is the suppliers’ responsibility
to ensure that the item provided continues to be used.
The following are two separate requirements regarding the
usage of CPAP;
A general monthly rental item requirement, and
Specific CPAP policy requirements regarding medical
necessity beyond three months of covered therapy
The general Medicare expectation is that the suppliers will monitor
usage of the rental equipment that is being billed. Therefore, it is
the suppliers’ responsibility to monitor on a monthly basis whether
the item provided to the beneficiary is still being used. The CPAP
Policy states;
“If there is discontinuation of usage of an E0601 device at any time, the
supplier is expected to ascertain this, and stop billing for the
equipment and related accessories and supplies.”
With this statement in mind, it is expected that if the supplier is billing a
monthly rental item to the Durable Medical Equipment Medicare
Administrative Contractor (DME MAC) they are attesting knowledge
of the beneficiary using the equipment. If the supplier does not
monitor on a monthly basis when billing to the DME MAC for a
monthly rental item, and it is found that the beneficiary has stopped
using the rental item, it is expected that the supplier will submit a
voluntary refund request.
In the event of an audit, if found that the supplier has been billing for a
monthly rental, and the beneficiary had stopped using the item, a
demand letter for recoupment will be sent.
TouchPointCare Key Concepts:
• Provide healthcare organizations with
customizable tools to improve ability to interact
with their patients and collect information
• Focus on low cost strategies, simple enough for
patients, sophisticated enough for providers
• Utilize subcription revenue model and create
win/win proposition with providers
TouchPointCare is designed to document contact
with your customers and record any change in
status related to their use of prescribed equipment
thereby facilitating Medicare compliance
“In summary, we are very pleased with the partnership we have developed
with TouchPointCare to date. Their system provides a very cost effective
telehealth solution for the company…in any given month, we estimate that
TouchPointCare will handle up to 5,000 phone calls on our behalf.
John Kolar
Advocate Home Care Products
TPC Performance Management
Prevent Fraud and Abuse
Improve compliance to yield better outcomes
Document improved patient outcomes
Collect data for value studies
Address adverse event issues
Improve patient data accuracy (and billing
Address patient notification issues
Identify and manage patient complaints
Address patient safety concerns
Conduct Patient Satisfaction surveys
Additional & Customizable
Questions can address:
Patient Safety
Oxygen Storage
Smoke Detectors and Fire exit strategies
Recent hospitalization
Other clinical issues
TPC Features allow you to:
• Create branching logic within question series
• Set response thresholds that will trigger alerts based on certain
responses and sent immediate emails
• Manage the call center function, so agents knows what to do in
every situation, (allowing non-clinical or non-expert people to make
• Identify and set the number of attempted calls you want to make to
each patient
• Trigger email alerts if unable to connect with a patient after multiple
attempts, (or bad patient data, or uncooperative patients)
• Provide multiple reports to manage all of the above and display all of
the data collected, using both Crystal and ChartFX reporting tools
for a very robust reporting function
TouchPointCare DME
• Set desired date ranges
• Build custom reports; by group or
individual patients to display responses
• Choose to display all data or only
“exceptions” or triggered “alerts”
• Manage all aspects of the program
The TouchPointCare DME
• Meet Medicare Client Compliance Requirements
• National Patient Safety Goals
• Variance report data keeps billing information accurate
and up to date
• Medicare audit data is available on-line, 24/7
• All data is gathered and stored on secure, HIPPA
compliant, servers with full back-up and recovery
• TouchPointCare DME pricing is “per completed call” with
unlimited reporting and analysis
• You make the calls, or ask TouchPointCare to do so…
• You decide the call frequency per customer and manage
your monthly costs
Technology Issues for
• Hosting eliminates many
IT hassles
• Available 24/7
• Secure Server
• Robust security
• Daily back-ups
• HIPAA compliant
• ASP.Net
• SQL Server
• Crystal & ChartFX
David Anderson, Ph.D., FACHE
[email protected]