9010 - Durable Medical Equipment Record Review Summary Form

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					       DURABLE MEDICAL EQUIPMENT RECORD REVIEW SUMMARY FORM


                                                         Requested    Outcome
                   Requirements                             by        (+)(-)(N/A)               Comments

                                                                      Record ID #
Directions: Randomly select 10% of records to include all
categories (I - IV) of services provided. Select minimum of 30
records or 10% in each category, whichever is greater.
Determine percentage compliance for each criteria. Calculate
average compliance for all criteria. Document results and
actions.
Basic HME Equipment
    Order Intake Form
    Instruction Checklist/Training Record
    Prescription
    Original Invoice/Delive
				
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PARTNER Compliance  Doctor
THE COMPLIANCE DOCTOR, LLC is a consulting firm that offers services to assist health care professionals at the task(s) of state licensing, National Accreditation, as well as Medicare Certifications in any outpatient, ambulatory type of business. We assist the client by providing them leadership and consultation along the labored process of the regulatory world in health care. There is never a job too small, nor too big, we can handle them all.