IVANS Helps Home Care and Hospice Providers Comply with New Medicare Mandates

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IVANS New eFormManager Easing the Administrative Burden of Face-to-Face Requirements and Transforming the Way Healthcare Providers Do Business

Michael Schramm, vice president of product and innovation at IVANS Inc., said, "Through eFormManager, we have expanded IVANS HIE offerings with an online signature application that helps providers gain approvals faster and facilitates Medicare reimbursements.”

IVANS, Inc. is putting thousands of healthcare providers on the fast track for compliance with Medicare Face-to-Face Encounter Requirements by enabling home health agencies and hospices to send patient documentation electronically to a physician in minutes using IVANS eFormManagerSM.

IVANS eFormManager, the latest HIPAA-compliant solution to be offered under IVANS LIME™ Healthcare Information Exchange (HIE) platform, is an electronic signature application that eases the burden of meeting healthcare mandates by eliminating manual processes and automating a healthcare provider’s administrative workflow.

On April 1, 2011, in accordance with the Patient Protection and Affordable Care Act, all patients needing Medicare reimbursed home health services are required to have a documented face-to-face encounter with a physician or nurse practitioner within 90 days prior to the start of home health care or within the first 30 days after start of service. This documentation is required in addition to completing and signing a Centers for Medicare and Medicaid Services (CMS) Form 485 (also known as the Home Health Certification Plan of Care), which is currently used by home health agencies to certify a patient’s need for services. For hospices, a face-to-face encounter must be made by a physician or nurse practitioner with a Medicare beneficiary enrolled in hospice care before their 180-day recertification and for each 60th day of recertification period after that date.

The purpose of these CMS face-to-face mandates is to achieve greater accountability when verifying a patient’s eligibility for home health services or re-certifying the need for continued hospice care, and that it be based on current knowledge of the patient’s condition. However, these requirements can be an onerous process, delaying patient care and impacting the way home care providers and hospices do business. Many providers are also concerned about setting up the resources required to comply on already-stretched budgets. IVANS eFormManager is an easy-to-use, cost effective solution that replaces the time-consuming task of mailing in or faxing a CMS Form 485 and face-to-face documentation, and can also be used with other patient documents including death certificates, referrals, doctor’s orders and supplemental orders.

Michael Schramm, vice president of product and innovation at IVANS Inc., said, “Over the past several months, we have been talking with our home health providers and hospices about the challenges associated with Medicare’s new face-to-face requirements. Now through eFormManager, we have expanded IVANS HIE offerings with an online signature application that helps providers gain approvals faster and facilitates Medicare reimbursements.”

Using IVANS eFormManager, the home health or hospice creates a CMS Form 485 and/or a face-to-face document either manually (e.g., scanning in the form) or electronically (e.g., via an EMR or form builder). The provider then attaches the document, indicating where a signature is required and securely sends the file to the physician via email. Upon receiving the document, the physician electronically inserts his signature and then emails the file back to the home care agency or hospice. Alternatively, the physician can print out the CMS Form 485 and/or face-to-face document, sign his name manually and fax it back to the provider. In both instances, the patient care documentation is captured and tracked automatically via IVANS eFormManager.

To further streamline the administrative workflow, providers can archive the files for up to 90 days as well as monitor face-to-face and Form 485 documentation in various stages of review. And, if the document is not signed within three days, IVANS eFormManager can automatically re-send the file, greatly reducing time and money spent on following up these documents.

Schramm said, “Most home care providers and hospices currently mail or fax face-to-face and CMS Form 485 documentation. They have told us the additional paperwork can be burdensome, duplicative and impractical, especially for those caring for patients in rural neighborhoods or in areas where there is a shortage of physicians. IVANS eFormManager ensures that providers are in compliance, as well as provides them with a secure and seamless way to get the authorization needed for patient care.”

IVANS, Inc. provides a national administrative health information exchange for the healthcare industry, including hospitals, home health, skilled nursing, hospices and practitioners. Headquartered in Stamford, Conn. and a CMS approved vendor, IVANS has been serving over 1,000 insurance and healthcare payers, and more than 135,000 healthcare providers since 1983. For information, visit http://www.ivans.com.


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Cecile M. Locurto
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