SWO alleviates confusion for PMDs

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Thursday, February 6, 2020

WASHINGTON – Providers of power mobility devices have perhaps the most to gain from a new standard written order that went into effect Jan. 1, stakeholders say.

The SWO replaces four types of orders, including the seven-element order, which was a sticking point particularly for PMD providers.

“Some providers were sending me thumbs up emojis when I told them about the SWO,” said Dan Fedor, director of reimbursement and education for U.S. Rehab, a division of the VGM Group.

The elimination of the seven-element order means PMD providers no longer have to worry about the date of the face-to-face evaluation, often a source of confusion between them and prescribing physicians.

Previously, that date had to be either the date of the face-to-face evaluation, or the date the physician co-signed and “stated concurrence” on the licensed certified medical professional’s evaluation—whichever was later.

“It was very confusing for the physician because the date of the face-to-face on the seven-element order wasn’t always the date a physician saw a patient if the LCMP came after,” Fedor said. “Physicians would tell providers I saw the patient on this date, not this date, and refuse to put the right date. Claims would deny if the date wasn’t correct. That the date of the face to face is not required on the SWO is huge.”

Also going away with the seven-element order is the 45-day timeframe for completing face-to-face evaluations.

“The biggest impact of the SWO, I feel, is it will avoid patients having to be re-seen for new face-to-face evaluations because of the time limit requirements,” said Sylvia Toscano, president of Pro-Med DME Billing/Consulting. “For PMDs, particularly CRT, getting the right documentation can be a complicated and lengthy process.”

While much of the documentation process for PMDs stands, streamlining the process—even in just these two instances—will help, stakeholders say.

“This is going to eliminate a lot of rework for PMDs,” said Andrea Stark, a reimbursement consultant with MiraVista. “These are the providers who have the most to gain in administrative burden recovery of all the providers.”