Page 21 - HME Business, May 2018

and the ability to stop bad claims from going out the door, adding pre-qualifying criteria up front; tying utilization limits to your payer and product combination — so many things.”
Outsourcing
Of course, another option is to outsource
parts of the RCM process to third parties. There’s where companies such as Prochant and the Allegiance Group come into play. In many cases, these companies will specialize in particular elements of billing and claims processing. For instance, Allegiance specializes in patient pay and Prochant focuses on insurance. Moreover, they usually offer tiers of service to help providers offload as much or as little as they need.
“We have one that’s called full-service billing,” Graham says. “That’s the traditional outsourcing of your billing, where we get a percentage of collections in terms of how we bill.
“The other is called staff augmentation,” he continues. “That’s an interesting model. That’s low-cost labor, essentially. We can plug and play resources. You need help with cash posting; you need help with denial management; A/R manage- ment; even front-end processes, such as data entry, CPAP resupply processing, and consign-
ment processing — even fax wrangling.” Outsourcing offers other benefits besides increased staff muscle and offloading costly
workflows; it harnesses institutional and industry knowledge. Because outsources are handling far more claims or collections than any single provider, they start to see trends develop that providers don’t, or develop best practices that would take a provider much longer to discover and implement.
“I think a lot of providers only know their busi- ness, they only know their niche, they only know their market,” Graham says. “They don’t have that worldview of what’s happening in the rest of the country, what’s happening with the other providers, what’s happening with their compe- tition down the street, or some of the best in class providers in our industry.
“When you work with an outsourcer like us, we do have that experience. We do work with these amazing players,” he continues. “We see behind the curtain and how they’re running their opera- tion. While we would never share secrets and trade secrets, we can help guide our clients down a path of best practices in what we know will ultimately to success.”
Ultimately, RCM will continue to see increased
relevance in the HME and adoption by HME providers. Moreover, outsourcing and technology will continue to play critical roles.
“Professional HME providers that embrace the enterprise approach to business with an ERP will be able to thrive on the 12 to18 percent margins that are putting old-school HME providers out
of business,” Bonafide’s Bailey says. “It’s not too late to upgrade your business and succeed in the new market, but it’s not going to be possible to compete without the right tools in place.” n
Renew
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Piecing Together
What’s Inside:
SleepBusinessStrategy . . . . . . . . . . .18 News, Trends & Analysis . . . . . . . . . . 8 2018OxygenAuditTrends . . . . . . . . . .12 Mobility Product Solutions . . . . . . . . . 23 HMEProductInventory . . . . . . . . . . . . 26 DEHPandCatheterUsers . . . . . . . . . . 30 The Strategic Landscape for the New Year is Falling Into Place
Harvesting
Your Data
What’s Inside:
Accreditation Renewal Time . . . . . . 21 News, Trends & Analysis . . . . . . . . . . 8 WPoortuanbdleCOarxeygOepnpSoortlutnioitniess . . . . . . . . . . . . . . . . .2146 HMEProductInventory . . . . . . . . . . . . 28 SalesCoachingvsManaging . . . . . . . .30 Providers Must Mine the Deep Roots of Their Patient Data
What’s Inside:
Medtrade Spring Product Preview . 24 News, Trends & Analysis . . . . . . . . . . 8
RAepmprotaecMhionngiteo-rCinogmfmoreOrcxeyg .e .n . . . . . . . . . . . 2114 CompressionProducts . . . . . . . . . . . . 28 Expanding Urology Revenues . . . . . . . 30
Oxygen’s Low- to No-Delivery Model Sees More Advances Portable oxygen has revolutionized the way that oxygen
pr u r n o v t i h d e e i r r s b b u o s i t n h e c s a s r e e s . f o I n r s p t e a a t i d e n o t f s t a a n n d k s , they provision portable oxygen ctaoknecethnotrsaetodresvtiocepsaatnieynwtshewrheothceaynlike . f r e F e o d r o p m a t t i h e a n t t ’ s s , b P e O e C n s u h n a a v t e t a a i n d a d b e l d e wa i t h the tank-delivery paradigm . With POCs, patients can now easily travel via air, rail, boat and car with higher confidence and comfort . Moreover, increased ambulation has been demonstrated to improve patient outcomes and reduce the probably of hospital readmissions .
For providers, they now have a business model that is essentially designed to cut operating costs . That model has allowed them to adapt to the myriad reimbursement challenges that have bombarded the oxygen industry, and helped them differen- tiate themselves to referral partners . In the time that oxygen’s low- to no-delivery business and care model has expanded, providers have gained a number of insights that have helped them implement further efficiencies and increase their business and care effectiveness . This month, we talk to various experts about how portable oxygen providers can take their businesses to the next level . Building on Portable
Oxygen’s Gains . . . . . . Page 16
March 2018 Volume 25, Number 3 hme-business.com
Management Solutions | Technology | Products
hme-business.com | May 2018 | HMEBusiness 21
“I think one
of the biggest
challenges is
most providers
just don’t
have the
means to staff
appropriately to manage the revenue cycle.”
— Joey Graham, Prochant
2018
For 10 years,
HME Business
Like ancient oak
PORTABLE OXYGEN
TAKING OXYGEN BUSINESS STRATEGY
TO NEW HEIGHTS.
has published its annual “Big 10” list, s s op e i t a ’ s k s fi t t ot i n a g m t h a a t u t r t i h n i g s y i n e d a u r ’ s s t r e y d t i ht i a o t n h a s learned to adapt to changes . At the
o a u s t e s n e s t e o o f f p u u r b g l e i s n h c i n y g; t t h h a i t s t l h i s e t , t t r h e e n r d e s w a s i i mt e p m a s c t t h i n a g t r t e h q e u i n i r d e d u s i t m r y m w e e d r i e a t b e u r n i n g attention . That wasn’t surprising given that HME was an industry that had seen relatively smooth sailing for so long, but was suddenly facing major regulatory, funding and market shifts . But now things are different . This industry has seen massive changes and weathered them . Now, new strategic concerns don’t send providers scrambling . Instead changes get them thinking about not only the responses to those trends, but the potential upsides, as well .
Suffice to say, 10 years later, this list serves an entirely different mindset . Where this year is concerned, the trends we’re seeing fall into place for the next 12 months include regulatory issues such as H .R . 4229 and Medicare Red Tape Relief, strategies such as billing non-assigned and revenue diversification, and business trends such as distributed operations and e-commerce . Take a look at the full list to see how you might need to adjust your 2018 strategy .
The Annual
Big Ten List . . . . . . . . .
Page 13
January 2018 Volume 25, Number 1 hme-business.com
trees with roots that delve deep into the earth, Hs t Mo r E e h p o r o u v s e i d s e o r s f p c a a n t i e t n a p t d i n a t t o a . v A a n s t d t r u l y ,
10 key trends that will impact providers this year.
that data is worth a fortune .
r e v A e s n p u r e o s v t i d r e e a r ms w s o i n r k t h t e o f e a x c p e a o n f d t h e i r
d r e e i mc l i b n u i n r g s e p m u e b n l i t c , t a h n e d y p m r i u v s a t t e w p o r a k y e t o r maximize their existing patient relationships, and also develop new appeals that resonate with entirely new clients and referrals . The data that providers amass over the course of doing business and providing care can help make that happen . Unfortunately, most providers aren’t leveraging their data to anywhere near the level they should be . They need to understand the elements that make up an effective data mining strategy and understand the sorts of measures, procedures and technology tools they need to implement in order to carry out that plan . Moreover, there are a number of concerns related to digging into and using patient data, such as legal considerations, that providers must incorporate into their data mining strategies .
This month’s cover story examines the various aspects of data mining and how providers can start digging into their patient data to produce results that will help their businesses grow . Harvesting
Your Patient Data . . . . . Page 16
February 2018 Volume 25, Number 2 hme-business.com
CHANGING GEARS
Growing your business by
tapping into claims and
patient data.
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Revving up standard power mobility’s revenues.
What’s Inside:
Smart Retail Purchasing . . . . . . . . . . 22 News, Trends & Analysis . . . . . . . . . . 8
Accrediting New Categories . . . . . . . 12 EnteringRespiratory . . . . . . . . . . . . . . 13 BathSafetyProducts . . . . . . . . . . . . . . 25 ToolstoEmpowerYourTeam . . . . . . . 30
Providers Can Build Successful Standard Power Business Models
Ever since the initial rounds of CMS’s competitive bidding pro- gram and the removal of the first- month purchase option, providers of standard power mobility haven’t simply suffered some setbacks, they’ve seen their entire business models hit a dead end . Like a cross country road tripper without a Road Atlas they’ve had to piece together entirely new pathways toward a profitable, sustainable business .
But many providers have been able to successfully set a new strategic course . Shaping today’s standard power mobility business model might not necessarily easy, but it can be done . The key lies in finding out where the core revenues are, how to expand on that foundation, and then find the products and strategies that can help supe up revenues and profit margins . The resulting strategy mixes retail and funded revenue, emphasizes forging the right vendor relationships, and requires pursuing new product avenues that appeal to mobility users .
We talk to some key experts in this month’s cover story to see where the real standard power revenues are at, how to strike the right blend between funded and retail revenue, and how to caretail in ways that will cement long-standing relationships with your customers .
Standard Power
Shifts Strategic Gears . Page 16
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April 2018 Volume 25, Number 4 hme-business.com