In the United States, medical fraud costs tens of billions of dollars each year, according to the FBI. To combat this problem, the Centers for Medicare & Medicaid Services (CMS) set up a task force to investigate alleged incidences of fraud, so the burden is on healthcare providers to protect themselves. Thankfully, technology now exists to help providers in the fight against fraud.
In the home health industry, agencies can prevent the potential for fraud by documenting patient care adequately and coding and billing accurately. Electronic visit verification (EVV) helps agencies in both of those areas.
EVV allows clinicians to document every step of the patient care process, including date, time and location of each home visit. An EVV app accessible through mobile devices puts these compliance features conveniently in the hands of the clinician at the point of care and helps agencies document proof of care in real time.
There are multiple benefits:
- BYOD. Employee bring-your-own-device (BYOD) programs continue to become more commonplace, with half of employers across all industries expected to implement BYOD policies by 2017, according to a global survey of CIOs by Gartner, Inc. When home health agencies give clinicians the freedom to use their preferred mobile device to remotely check in, take notes and log data, the outcome is clear: working smarter. And being mobile-agnostic is key. In a recent cross-industry survey, 94 percent of respondents primarily used their cell phone for certain data functions, while 66 percent used their tablet.*Billing. EVV allows agencies to eliminate costly, time-consuming paperwork.
- Billing is faster and more accurate with EVV. Data errors are reduced when clinicians are entering information in real time, versus taking notes and recording visits later.
- Processing. An interface between EVV and billing software can speed up the billing, revenue cycle management and reimbursement process. In addition, the EVV app time-stamps the clinician’s check-in and check-out times, capturing accurate data for employee payroll processing.
- Scheduling. Missed-visit alerts and appointment changes can be sent directly to a clinician’s device. The GPS feature can also reduce mileage costs.
- Compliance. HIPAA-compliant, data-secure, encrypted EVV is possible with mobile devices. Additionally, the mobile app uses the GPS location tied to a patient’s electronic signature. Having secure access ensures the agency is complying with HIPAA regulations by reducing the potential for unauthorized access to patient information.
- Audits. EVV prevents the conditions that lead to improper payments and provides an effective response to an audit. Proof-of-care data is readily accessible, including the additional proof of care provided by patient signatures.
- Patient outcomes. Clinicians spend less time on paperwork and more time on patient care. This means better business for home health agencies: favorable reviews, word-of-mouth marketing (the best kind) and happier clinicians. When people in a variety of industries were asked which apps they don’t have access to on their mobile devices, but would make them more productive, the leading response (44 percent) was a work application or system.*
Agencies that don’t use EVV will find it difficult to remain compliant and competitive. They leave themselves wide open to risk of fraudulent claims submissions, billing for false care visits and disrupting cash flow by spending too much time on paperwork and less time on patient-focused care. Several states, including Florida, South Carolina, Illinois, Tennessee and Texas, have been mandating EVV for home health in recent years in an effort to curb fraud. This trend is likely to continue as EVV products continue to become increasingly sophisticated.
* Evolve IP’s 2014 Mobility and BYOD Survey: http://pages.evolveip.net/mobility-survey-results-resource.html. Totals may exceed 100 percent because multiple responses were permitted.