One of my funniest memories from surveying was many years ago at a small DME company in the Midwest. The staff was pleasant and accommodating and had been well prepared for the survey. But for some reason (probably related to a co-worker’s retelling of a “bad” survey that she’d gone through), the staff was pretty nervous about the accreditation visit. I pride myself on NOT presenting an intimidating attitude, but the staff at this place thought I was the police, the IRS, and the guy in charge of the Inquisition rolled into one. I tried my best to put the staff at ease. At one point, I asked a customer service representative about how they conveyed information on the patient’s rights and responsibilities to new customers. She fumbled through a pretty good answer. I asked her if she could name one of the responsibilities and she answered that they need to inform the company if they move or if their insurance changes (a good answer). I asked her if she could name a right and she froze up. Finally, she took a deep breath and blurted out: “The right to remain silent”.

Its common and absolutely normal to be a little nervous during a site visit. But well prepared, competent staff members who understand their job and know the company’s procedures have nothing to worry about. Despite all the preparation in the world, a question can throw a staff member off ‘their game’, especially if it takes them by surprise. An effective strategy to combat this is simply to make sure all staff members are prepared for a surveyor’s questions. This can be done through mock surveys and role playing as you prepare for survey.

Expect a surveyor to ask questions about the company in general. Typical questions include asking about the company’s mission statement, how the flow of information and workload happen at an organization, and who makes decisions within the company.

Also expect surveyors to question an individual about their role at the organization, how they were trained and oriented to their job, who they report to at the company, and how they perform their job duties. Surveyors usually drill down with clinical, billing, and delivery staff to ask them about specific tasks they do as part of their job. This includes asking staff to demonstrate their job duties by showing them how they would perform a procedure, set up and teach a patient/customer about a piece of equipment, or do actual billing on the company’s billing software.

Questions are typically specifically aimed at a person based on their job title. Some of the most common and typical questions include:

Billing Staff:

• What paperwork are you looking for in order to file a claim for a piece of DMEPOS?
• When would you use an Advanced Beneficiary Notice (ABN)?
• How do you bill and collect co pays or deductibles?
• Under what circumstances would you waive collecting a co pay or deductible?
• Show me on the billing software how you bill a claim.

Delivery Staff:

• Please give me a “tour” of your delivery vehicle and show me what you carry for safety and infection control.
• What type of paperwork do you fill out for tasks such as vehicle check out and route sheets?
• How do you separate clean equipment from dirty equipment if you carry both in the vehicle?
• How do you secure equipment during transport in the vehicle?
• When showing a patient/customer how to use a piece of equipment, what paperwork are you filling out and what paperwork do you leave with the new patient/customer?
• Show me how you’d set up a piece of equipment on me (the surveyor). {A mock equipment set up}
• How is your company’s on call system set up and are you on call after hours?

Clinical Staff:

• Did you have experience with the type of equipment you are using at this company prior to working for this company?
• How did the company train you?
• Who do you report to? If you don’t report to a clinician, do you have another clinician to consult with if you run into problems or issues you don’t understand?
• What happens when you go on vacation? {Particularly if the organization only has one clinician}
• What ongoing training and in-service programs do you receive at the company?
• Are you licensed in all states where the company has patient/customers? Can I see your licenses?
• How is your company’s on call system set up and are you on call after hours?

Retail Customer Service Staff:

• How do you maintain patient/customer confidentiality in the store?
• What do you do if a patient/customer brings in a used piece of equipment to return it?
• How would you handle a customer complaint? What paperwork do you use to document the complaint?
• Do you know which insurances you can accept for DMEPOS customer/patients?

Of course, the potential list of questions is endless. But everyone at your organization should be aware that the surveyor is not out to trip them up and will only ask questions that are pertinent to accreditation given the position the person holds at the organization. Staff should be coached to answer questions to the best of their ability and to remember that it is always OK to say they don’t know the answer off the top of their head, but they know where to find it (policy and procedure manuals) or they know who to ask for clarification (their supervisor, the manager, or the owner).