Summary
- Careful understanding of how and who can access the information.
- Do all healthcare providers get equal access?
- Now is the time to resolve these issues before more billions are spent and no coherent system will evolve.
Analysis
Since 1986 many providers have been able to access the "common working file". This is a data base the medicare and others use to determine benefits and how they are delivered by all providers.
The problem facing the e-health system is that many providers cannot access the information. Many home care companies have been asking for access to the system to determine if a patient has had a piece of equipment prior. CMS has mandated that a patient in the home care setting can access a product such as a walker or commode chair once in a lifetime. If the patient gets better and no longer needs the product they tend to discard the item and then later on find they need another one, they will be denied for already having one prior. This causes a vast amount of paper work and lost time billing and denying claims that could have been resolved by the providers access to the common working file.
I personally have been lobbying for all provider access so every issue can be resolved immediately and not after hours of billing and denials as well as the embarrassment of the beneficiary when he or she has to be reminded that they already had an item same or similar.
Equal access has to be established long before any system with any credibility will evolve.
Few realize that CMS wants all to be e-health now yet that refuse to put into effect the tools to establish a valid program.
