I am freaking out about a DME inspection. What do I do Part 2:
At the time of the inspection the inspector may ask you to prove that you are compliant with all of the 30 Supplier Standards as they apply to your practice. Providing sample warranty information and Instructions for Use (IFU) on any DME item you provide is just one category of items they may wish to review. You may be requested to have this for every category of item you selected in your enrollment application. Therapeutic shoes, AFO, surgical dressings are all typical of most DPM portfolios which should be on hand. These may be obtained from your vendors. Failure for your office to provide samples of such information regarding proving compliance with the 30 Supplier Standard can result in a failed inspection. There is a wide range of other materials which the inspector may request. Hence the need to fully understand the implications of the DME Supplier Standards on your practice. Should you fail an inspection, your DME Supplier number is subject to suspension and/or termination, which of course can be appealed. This lengthy and arduous process can be avoided by following the rules.
The inspector(s) also must follow some simple basic rules:
They must show proper photo ID and they should give you or permit for you to record their employee number or a copy of the ID.
They can take photos inside and outside your office
They can ask for any templates proving your compliance with any of the 30 Supplier Standards
They are not permitted to obtain or secure any PHI (they can’t look through or scan patient charts).
If you are unsure of the rules, it may be more cost-effective to contact a consultant who is well versed in DME enrollment and inspection matters as opposed to taking a chance on one’s own. Having a professional to advise you can assist with both the application process while minimizing or avoiding a lengthy and costly appeal of a suspension or termination.
The enrollment carriers are attempting to reduce fraud and abuse and preserve the Medicare Trust Fund. We all should applaud these actions and instead of complaining about them should embrace the inspection process as one which protects our ability to take care of our patients and to ensure that Medicare will be there for us and our loved ones.
Most suppliers pass inspection with little fanfare and will tell you that this is an easy 5–10-minute intrusion on your time. Proper preparation is key! Having employees and an office manager and physicians who are well versed in the process is the best way to ensure that your inspection will be smooth and painless.
