Value-based care: Embrace generic writing

Q. How can providers better support HME companies in value-based care models when it comes to wound care order writing and diagnosis listing in the medical record?

A. Generic order writing is really the key here. With thousands of wound care products on the market and new HME companies cropping up daily, one can imagine it becomes increasingly difficult for the key players in the industry to keep up. When providers implement generic wound product order writing as routine practice, it can significantly reduce delays in access to appropriate products and supplies.

Alternatively, when a provider writes a brand-specific order, there is an undoubted uptick in the amount of back-and-forth communication that occurs, as HME companies must coordinate with providers to get approval and new orders for off-brand or generic substitutions when insurance restrictions or required authorizations prevent a brand-specific order from going through.

Orders placed through a standard e-script platform simplify the ordering process for both the prescriber and the HME. This reduces documentation errors, inaccurate product size selections, and ensures that all necessary documentation is acquired from the outset.

Lastly, diagnoses and the order they are written in matter to ensure the order is approved. This becomes challenging with wound care. Most patients with open wounds don’t just have one or two diagnoses in the medical record. Wounds are often a byproduct of many comorbidities that may take precedence during the visits where wound care product orders originate. Recognizing the importance of wound ICD-10 codes being included as a primary or secondary diagnosis when attempting to gain insurance approval and any available reimbursement for wound care products is critical.

Any aspect of the case management process that can facilitate streamlined processes and reduces delays in care, keeps the patient in focus and enhances their likelihood of achieving positive health care outcomes.

Kaitlyn Rios, PT, DPT, CWS, is vice president of clinical business development for DermaRite Industries. Reach her at KRios@dermarite.com.