Page 14 - HME Business, January 2018

2018 Big 10 List
had been downloaded using its AirView remote patient monitoring platform. That’s just one vendor. Factor in all the CPAP makers, and you can quickly get an impression of the scale involved with only the sleep segment of the market.
Globally, the number of remotely monitored patients grew
by 51 percent to 4.9 million
during 2015, according to researchers Berg Insight.
blend of technology to help patients while providing a solid business case for HME providers’ continued — and expanded — role in the post-acute care market. The key is getting in on the ground oor. Providers of sleep, diabetes and oxygen products will want to monitor this trend during 2018.
with them a long time maybe retire or whatever, they want to make sure that they are matching what they say they do.”
Also, it’s important to keep in mind how essential Medicare accreditation is from a broad business perspective.
Looking ahead, Berg
reports the number of
remotely monitored patients will grow at a compound annual growth rate of 48.9 percent to reach 36.1 million by 2020.
Where HME is concerned, connected medical devices, such as sleep therapy equipment, accounted for a whopping 71 percent of total remote patient monitoring revenues in 2015, according to Berg.
The fact that HME is at the center of that growth is critical. With sleep as
the foundation — or, better yet, launch pad — for remote patient monitoring, other categories will take off. There are various sectors of post-acute care that are starting to see remote patient moni- toring take root and expand, and those represent key opportunities for HME providers to get involved.
For starters, diabetes care is a big opportunity. Already we are seeing glucometers that use wireless technology to update patient performance metrics. Another opportunity for increased remote patient monitoring in the HME industry is the respiratory care sector. Already some manufacturers, such as
O2 Concepts, are remotely monitoring POCs for diagnostic and maintenance information, but from there, we can see the foundation being laid for physicians, RTs and other clinicians involved in the patient’s care to start using collected data to engage in targeted outreach and help improve compliance.
Ultimately, remote patient monitoring represents an enticing and rewarding
Accreditation Renewal
This year marks a major year for accreditation renewal. As Sandra Canally, RN, president of deemed Medicare accrediting organization The Compliance Team, points out, the last time a large bulk of providers were accredited was
in 2015, so given accreditation’s three- year renewal cycle, 2018 is going to be another big year.
If you didn’t get out in front of this in 2017, now is the time to hustle, because accreditation renewal takes work and time. Fortunately, nothing has really changed from a CMS perspective.
“They’ve summarized some things there, but in terms of the actual quality standards that all the accrediting orga- nizations need to adhere to nothing has really changed,” Canally says.
This means that providers must work
on the fundamentals. They should start reviewing their policies, and making
sure that the processes that they have in place match their policies. In many cases, providers will be in compliance with their AO’s standards, but their procedures might not match up simply due to oversight and other factors. This “renewal season” offers an opportunity to x that common mistake.
“Everybody should be reviewing their policies on an annual basis just to see if anything needs to be changed,” Canally notes. “Especially if they’ve had new staff come on board older staff that’s been
14 HMEBusiness | January 2018 | hme-business.com
Management Solutions | Technology | Products
This year marks a massive year for accreditation renewal. Is your business in front of the rush of providers renewing?
While Medicare accredi- tation means an HME can bill DMEPOS claims, other payers use it as a gold standard. So even if a provider isn’t doing
much Medicare, it still needs to use that accreditation to ensure it will pass muster with private payers and health plans.
“Accreditation covers more than Medicare,” Canally explains. “We see
a lot of Blue Crosses, a lot of managed care—the Aetnas, the Cignas, the big guys—will not only contact the accred- itor to verify the dates of accreditation for a particular DME, but they will also drill down the product lines that they’re accredited for. In other words, they’re mimicking Medicare.”
Billing Non-Assigned
Because of competitive bidding and other funding pressures, many providers are starting to bill non-assigned.
Essentially, the provider elects to not participate in the Medicare program and provides equipment on a non-assigned basis. This means the provider won’t accept Medicare’s allowable funding, and is instead collecting directly from the patient. The provider then les the claim with Medicare on behalf of the patient, but the Medicare reimbursement goes directly to the patient. This means that the provider can change more than Medicare’s rate for that particular item, and gets its revenue from the patient.
This is a trend that has been growing increasingly popular, particularly in more rural areas where providers have low volume and have been disproportion- ately hurt by the national expansion of