ANSWERS TO YOUR INDUSTRY QUESTIONS Does it make sense to expand into the infusion therapy business today?

ONLY IF YOU want to manage a very different business than home medical equipment. The $4 billion infusion therapy market represents an opportunity for HME companies to expand their lines if the growth potential in their current market is limited or their customers are interested in these services. Both businesses operate with similar selling strategies, but the HME business is much more Medicare dependent than the infusion therapy business.

There have been an equal number of successes and failures in managing these businesses. The managers of the failures have tried to integrate the businesses with their HME business and learned the hard way that successful managers have kept the businesses separate at the operations and financial levels. There are some synergies in marketing so these can be managed by the same person.

The successes have been regionally based and the managers in these companies have leveraged their management talents while decentralizing the functions of the business into separate product lines. HME and infusion therapy cross with enteral therapy, and both types of companies can be successful managing this product line.

-Answered by Alison Cherney, president of Cherney & Associates, 9719 Concord Pass, Brentwood, TN 37027; 615/776-3399; fax: 615/776-3492; e-mail: CherneyAJ@aol.com; Web site: www.cherneyandassociates.com

My company puts unreconciled reimbursement amounts on "pink slips" because they do not know where to apply them. In the case of obvious overpayments, we do put through refunds, but what about other unreconciled amounts?

THE PRACTICE YOU describe sounds like something I call "unapplied cash." This is money you received and deposited but when you tried to apply it to the detail on a known patient account, you couldn't get the payment to match the charges in accounts receivable. Sometimes, this is a result of an overpayment. Sometimes, it is a result of the payment being issued in a bundled way, but the accounts receivable detailed has line-item detail. Sometimes, a time crunch did not allow your staff to post the money to the detail.

You said you produce a pink slip to explain the reason the money could not be applied. But is the amount posted as a credit balance within the actual patient account as well? The money needs to be in the patient account even though it leaves a credit balance. You should be able to run an accounts receivable report of all credit balances, and your staff should work that once a month. If a refund is necessary, that's when you should handle the paperwork to issue a refund check. Don't have your staff be in such a rush to issue refunds! Do you know any business that issues refunds in less than six weeks?

All businesses like yours have unapplied cash. However, you should have your staff go through all your unapplied cash (open credits) in accounts receivable once a month. This way, secondary bills can be printed with a certain amount of accuracy. If you don't reconcile these credits in an account, it will screw up your secondary bills. Having these "pink slips" outside your accounts receivable system will create a paper nightmare.

-Answered by Lisa Thomas-Payne, MRS/Medsource LLC, 4665 Indian School Road N.E., Suite 112, Albuquerque, NM 87110; 505/255-0004; fax: 505/255-0550; e-mail: lthomasp@aol.com