CAP/DME Forms: A Comedy of Bureaucracy
Ah, the obscure world of Tricare reimbursement – where Reimbursement Directors try to forget Tricare's even a payor, and unnecessary paperwork thrives. Yes, nothing screams excitement like TRICARE regulations and the thrilling process of digging line by line through your Medicare Cost Report simply because your Tricare regional contractor said to.
For the uninitiated, CAP DME stands for capital and direct medical education costs. Unlike the Medicare and Medicaid rates hospitals know and love, TRICARE rates do not reflect Capital and DME expenses.
TRICARE, of course, likes to keep Reimbursement Directors on their toes by requiring a separate submission for CAP/DME. Before I sound like a complete drama queen, I'll point out that this form only takes about a half hour. I have no issue with the size of the form or the fact that it's actually very easy compared to most Reimbursement filings. My issue is that TRICARE already has the data they're asking for on the form. So why bother making us fill it out?
TRICARE could easily query the HCRIS database for the very Medicare cost report data it requires hospitals to manually fill out.
So yes, annual CAP/DME forms are just a small annoyance and not nearly as onerous as the real challenges facing Hospital Finance professionals today. But, as an industry, let's start making efforts to leverage technology to reduce workload. It may just save us a 30-minute form today, but it's a step toward making this a more efficient industry. After all, we're still inputting similar data into multiple cost reports, and those aren't just a 30-minute annoyance.
