Electronic Certificates of Medical Necessity

Paper Summary:

Medical billing can now become a relatively painless process for the personnel in a medical facility through the electronic filing of certificates of medical necessity (e-CMN). This paper explains how manually filling out paperwork is very time consuming and is not very cost effective. However, the technological advancements created in the area of medical billing are very efficient. It looks at how, while many offices now fax the CMNs, the incorporation of e-CMNs into the medical office and billing process decreases overhead costs, reduces paperwork, and helps substantially with the on-going battle to comply with the ever-changing Medicare requirements. It argues that, while each of the previous reasons is enticing enough to consider incorporating e-CMNs into the office routine, the increase of revenue is certainly a major benefit and is the direct result of the time reduction with the filing process.

From the Paper:

"In September of 2001, the Centers for Medicare and Medicaid Services revised the Medicare Program Integrity Manual (PIM) to include the acceptance of faxed and electronic CMN's and other electronic communication between suppliers and physicians while improving program integrity (Bachenheimer, 2002). The PIM included instructions for how e-CMNs should be created and used, while also specifying that they must "adhere to all privacy, security, and electronic signature rules and regulations. Additionally, e-CMNs must contain identical questions/wording to the paper CMS forms, including the same pagination, and identical instructions along with definitions as printed on the back of the hardcopy form" (McClinton, 2002)."

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