Billing/Reimbursement
Forward Focus
History repeats itself, but nothing stays the same. In the medical industry this is definitely a true statement. In the daily changing world of HME and pharmacy, providers must be willing to make necessary changes to stay in the game and survive.
We are a very young industry that seems behind on technology, software and other means to streamline business models to be as lean and mean as we need to be. But there programs available to assist you.
You have heard me say over and over again, for example, “It can all begin and end with intake!” Do you currently utilize software to ensure the intake is correct and the patient qualifies prior to the equipment and/or supplies being delivered? Are you utilizing your computer system to input the intake or are you still having your intake coordinators work the intake on paper before entering it in the computer system?
How many times has it happened that your intake personnel did not obtain all the information you needed? I know … too many times. I have seen too many write-offs on your accounts receivable (AR) on equipment that should have never been delivered in the first place. We have to streamline beginning at intake, and this, in turn, will increase productivity.
In beginning activity-based costing procedures for clients involved in the first round of competitive bidding, I always discover so much waste. This waste costs the company money. We just cannot afford profit loss amid all of the reimbursement cuts, capped rental on oxygen, 13-month rental caps on other equipment and the continuous changes in policy affecting reimbursement, not to mention the expansion of competitive bidding.
Audits are also costing this industry a lot of money. We have the most regulated industry in the country next to defense contracting. Both of these involve government dollars, and, as government dollars are tied to reimbursement, we are scrutinized closely and audited frequently.
The government received back $28 for every dollar spent auditing health care providers in 2002, according to statistical data. This is a big business, and with this kind of return, do not expect it to stop: Expect it to increase.
Embracing technology, which will save lots of time and money, can also help you be prepared for an audit. Educate your staff on how to work audits, and consult an expert who can assist you in getting it right the first time. Why pay back the money if you do not have to?
