Features
Dare to Soar
The majority of my life is spent on airplanes visiting HME providers throughout the United States, Puerto Rico and the Virgin Islands. As I fly from place to place, I see many similarities among these providers. The primary attribute I always notice and admire is the love and care that they give their patients. Most independent providers started their companies because of a personal experience with a loved one, or the love they have for helping others. Does this change just because a few laws change or reimbursement is cut? Absolutely not!
New provisions in the Medicare Prescription Drug, Improvement, and Modernization Act, have made this a time of uncertainty for the home medical equipment industry.
But HME providers have experienced many ups and downs through the years, and regardless of the obstacles, most have continued to fly strong. Now is the time to stay in this industry-and grow stronger than ever.
Take a close look at your business. Write a plan, including policies and procedures on how you intend to streamline your billing and intake departments — as well as your entire company. By focusing on accounts receivable (A/R), you will be amazed at how much your business can improve, even in difficult conditions. How many HME owners truly know how to work A/R and denials? Not many! To start, consider the following:
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Work denials in a timely manner — Denials must be worked within 120 days from the date of receipt on the EOB (explanation of benefits). You must have a written policy and procedure stating that your company will work denials within 72 hours from the time they are received in your office.
More importantly, follow up to ensure those denials have been worked. Education is always needed in the denial department. Make sure employees are not just re-transmitting all denied claims again and again. Teach employees how to work each and every denial code.
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Work accounts receivable efficiently — Your best biller should be the person primarily responsible for making sure your A/R is worked effectively. Set goals and timelines for each insurer and employee. Because each A/R is worked differently, print each one separately. Print Medicare primaries and secondaries together, Medicaid, patient portions, and then print each insurer. Your employees should be able to mass-print all outstanding secondaries to get them in the mail or transmitted quickly.
Always follow up daily on what has been assigned to each employee. Remember that when you are working denials, you are working A/R.
