I have been raising awareness about the direct link between documentation and surgical dressing supplies – and why DME companies have become so “demanding” in terms of the documentation they need to see. The DME companies have been audited nearly to death by Medicare and have paid back huge sums of money for dressings that patients really needed. Unfortunately, Medicare determined that the payments for the dressings were “improper” because the clinical documentation didn’t meet the requirements – particularly for alginates and collagen. The auditors appear to have exceeded their regulatory authority in terms of how they interpret the Medicare requirements (more on that to come) – but since the auditors can do pretty much whatever they want, we have to change what we are doing.

Here’s an email that I got last week from a patient. I promise I did not make this up just to prove a point:

Dr. Fife,

Again I cannot get my supplies for Medicare because of the lack of proper documentation. At my previous wound care center, when they took the dressings off, they laid them out so that the doctor could see how much drainage was in the dressings. At this wound center, they throw the used dressing right into the trash. I guess they  expect the doctor to look through the trash to know what it looks like. Of course, then it was documented that I had “scant” drainage which was incorrect. The dressing was soaked through. And now I will have to wait another two weeks before I can possibly get the correct documentation charted so that I can get my dressings from the DME. I need an alginate foam and I can’t get it because the drainage amount recorded was incorrect.”

I want you to use my real first name if you post this letter.