Can I eSign Missouri Medical Records Release

Can i document type e sign medical records release missouri

The Centers for Medicaid and Medicare Services would like to welcome you to the Payment Error Rate Measurement (PERM) Overview for Medicaid and Children's Health Insurance Program (CHIP) providers. The Improper Payments Information Act (IPIA) of 2002 (amended in 2010 by the Improper Payments Elimination and Recovery Act (or IPERA) requires the heads of federal agencies to annually review programs that may be susceptible to significant improper payments. Both Medicaid and CHIP have been identified as programs at risk for significant improper payments. In order to comply with IPIA and related guidance, CMS developed the Payment Error Rate Measurement, or PERM. PERM uses a 17- state rotation to measure the improper payments made in fee-for-service, managed care claims submitted in the Medicaid and CHIP programs. The 17-state rotation means that each state is measured only once every 3 years on a recurring basis. The PERM measurement then establishes an error rate for each component. It is important to note that the error rate is not a "fraud rate" rather a rate indicating that payments made did not meet statutory, regulatory, or administrative requirements. As a provider, any of your fee-for-service claims are subject to medical review. It is important to keep in mind that even if your state is undergoing the PERM measurement, it is not guaranteed that you will have a claim under review. However, if one (or more) of your claims is selected you should expect a medical/service records request from the current CMS PERM Review Contractor. This request will come from a Customer Service Representative of the current CMS PERM Review Contractor who will work to assist to identify the appropriate person within the provider office. The Review Contractor will explain the PERM process, the authority governing PERM, as well as coordinate with the provider the appropriate contact person to formally submit the medical/service records request. Once this information is identified, the current Review Contractor will fax or mail the medical/service records request to the providers' office. The request sent to the provider will detail the documents needed for each medical/service records request and will provide instructions for how to submit the requested records to the PERM Review Contractor. Please note that with each record request will also be a PERM cover sheet. It is extremely important that this cover sheet be provided with each record requested and submitted to the current Review Contractor no later than the due date printed at the top of the "Initial Request for Records" letter so that the claim is easily identified. The due date at the top of the "Initial Request for Records" allows a maximum of 75 days to submit the requested records. Receiving the requested records is critical to the measurement; as such the current Review Contractor will provide reminder calls and letters throughout the 75 day period (30 day, 45 day and 60 day) until the records are received. If the Review Contractor determines that the documentation submitted is insufficient for the claim requested, additional documentation may be requested before the review is completed. Providers will then have 14 calendar days to submit this documentation. All medical/service records will be reviewed by the current Review Contractor and proper or improper payment determinations will be made on the basis of the medical/service record documentation provided and your state's policies. No documentation and insufficient documentation error findings have been the largest source of errors in the past PERM measurements. CMS would like to stress to providers that all error findings will adversely impact the state and national error rate. Providers should note that all requested claims with no documentation or insufficient documentation will automatically be identified as an improper payment . CMS is required to recover all improper payments and the State may sanction providers with improper payments. Through past measurements, CMS has identified common mistakes that providers make in submitted medical/service records. These mistakes include: not responding within required timeframes, submitting records for the right patient but the wrong date of service, submitting records for the wrong patient, not submitting readable records (i.e. Poor quality of faxed documents, etc.), not copying both sides of two sided pages, and marking or highlighting certain parts of the records which obscures important facts when copied. CMS has also identified some best practices including: designating a point of contact the makes the PERM request a priority the moment it is received, thoroughly reading the medical/service records request and identifying the appropriate dates of services requested, being aware of the importance of cross-referencing names changes (including newborns) and assuring that the recipient name on the record request is the same as on the actual claim sampled. Providers should note that sending billing information is not sufficient proof that services were provided, and again no matter how small the paid amount of the claim, the submission of the requested medical/service documentation is critical in the PERM measurement. CMS also suggests providers do the following to ensure success: CMS advises that providers keep abreast of state policies regarding documentation requirements for relevant provider types and closely monitors their states' Medicaid agency website and other resources, providers should maintain a copy of the documentation for services performed outside of the provider office that support the claim and as often noted in the medical community "if it was not documented, it was not done?" We certainly hope that this information provided on the medical/service records request process for PERM was helpful. If you have additional questions we encourage you to visit the CMS PERM website at www.cms.gov/PERM where we have a dedicated "Providers" page. The "Providers" page includes information on when your state will be measured by PERM, in addition to your state contact information. It also includes samples of the medical/service records request letters and other documents referenced in this presentation. CMS will also post any updates for providers to the page as well as contact information to contact PERM staff within CMS directly through the PERM Provider e-mail address. We look forward to working alongside you in your next PERM cycle and are available to answer any questions you may have. Thank you.