Streamline for Positivity

As we approach another Medtrade, I write this article thinking about the calls I have been receiving from providers throughout the country and the changes we are facing in our industry. We have made some strides in reaching the goals of delaying competitive bidding, stopping the transfer of entitlement of oxygen and many other small successes this past year. But, we have a long way to go and must keep fighting.

It is up to us in this industry to continue fighting until competitive bidding is ended, not simply delayed. There is a lot of confusion among providers who think that competitive bidding is gone, but it is not.

How many of you have called your federal representatives since we received the delay? I understand the phones are not ringing in their offices like they were. Why? Keep calling and writing and get your beneficiaries involved. It is their rights being stripped and taken away.

With the 9.5 percent cut in reimbursement effective Jan. 1, 2009, oxygen capping out Dec. 31, 2008, for all patients who have been on oxygen for 36 months and deductibles hitting hard the first quarter … are you ready?

How much revenue have you put back as a cushion to ensure you are going to stay afloat the first quarter? Many of us have cut employment, streamlined and worked on diversifying into other sources of revenue and made additional changes that will be necessary to continue to profit and stay in business.

As I share with my clients when I walk into their offices, your raise is in your own office.

Collect your accounts receivable and patient balances. I have seen some of the highest A/Rs I have ever seen in the past two years. How can we afford such high A/Rs and deductible ratios with all of the cuts and changes?

What I find is that some HME owners and managers do not understand the billing and collecting processes, so they depend on their employees just to tell them the truth about what is going on with A/R and denials and collections. Unfortunately, if you as an owner do not understand how to manage your own A/R, how do you know what your employees are doing is correct and efficient? You don’t!

You must have a denial management software system in place to be able to manage your denials in a timely and efficient manner. I put such software in many years ago in my billing company and could never live without it. Denials are A/R, so why not make sure you never move into the “over 90-day” column when you do not have to?

Advance beneficiary notices are not being utilized appropriately. Do you let all the patients that come into your company know about their rights to upgrade a piece of equipment? Just because Medicare pays for the Volkswagen does not mean patients do not want the Ferrari. Always let your patients know what options they have.

When it comes to the baby boomers, these Medicare beneficiaries are going to upgrade and get what they want, not just what they need. Believe me, you all know I will have a star-studded, leopard-print cane with rhinestones when I need a cane. Upgrade me, Baby!! ·

There are many ways we can streamline our businesses and make them profitable and service our patients like we need to do. We just have to look at our flows and processes, look at our intake department, our delivery operations, our billing and collections procedures and make changes now.

Remember that intake is everything. A large percentage of denials are the result of poor intake. Start there and work your way through your company. You cannot afford not to. Also, make sure you have an efficient educational program for your employees so they understand updates and changes as they occur — not six months following a change leaving a lot of clean-up to do. Clean-up costs money and time not well spent.

Let’s stay positive as we approach Medtrade, attend the sessions, walk the show floor looking at new equipment to diversify into and network with other providers to learn what they have done to be successful. Networking is vital in this industry. We can all learn from one another, so let’s take this opportunity to do so.

Jane Bunch is president/CEO of Jane’s Healthcare Consulting based in Marietta, Ga. A reimbursement specialist, Bunch delivers educational seminars, helps develop corporate compliance plans and serves as a consultant for fraud and abuse cases. She can be reached at 770/366-0644 or by email at [email protected].