The Click of a Mouse

These days, businesses are learning how to do more with less staff. This means that companies, including HME providers, must find ways to increase productivity without adding employees or compromising service.

Information technology provides one solution. The HME industry tends to lag behind in technology but can ill afford to perpetuate this trend. Not only do we have to take advantage of advancements in technology, but we must also become more adept at using our existing software and its capabilities.

Many software packages come complete with data tracking of all types. In fact, tracking things like CMNs or accounts receivable should be a basic function of any HME software package. If the data is in your computer system, you should be able to retrieve it.

With today’s software, you should be able to use and manipulate the system easily for varied purposes. For instance, as a manager, you should know what business transactions transpired on a given day — everything from how many orders for what type of items to the number of pickups and electronic claim submissions. A software-generated daily activity log can facilitate how management monitors business trends.

“Efficiency comes through edit reports and automated features,” says Brian Williams, marketing manager for Computer Applications Unlimited, Harrisburg, Pa. “The most basic timesaver must be electronic claims submission and automatic posting.”

Another way to submit clean claims safely and efficiently is to use audit reports, which can tell you which claims will process and which will not, according to Williams. Rather than waiting for a denial, isn’t it better to submit clean claims to begin with? This a definite advantage and a way to capitalize on the available technology.

No CMNs?

Currently, we remain dependent on paper CMNs, though most of the industry eagerly awaits the final adoption of electronic or e-CMNs.

Ultimately, there should be no need for a CMN at all, according to Greg Taylor, vice president of business development for Duluth, Ga.-based Brightree/Fidelis Software, which offers an Internet-based IT solution. Eventually, Taylor predicts, patient eligibility and clinical assessment will be checked just prior to claim submission, and all three will be accomplished electronically.

“IT is an essential enabler of our transformation from the current, 40-year-old payment process to the future of our businesses,” Taylor says. “Real-time IT presents a tremendous opportunity for our industry.”

In fact, real-time IT will allow HME providers to communicate electronically with insurance companies, manufacturers, doctors and other health care industry businesses. To illustrate his point, Taylor explains that when a person visits a pharmacy to fill a prescription, his or her claim is adjudicated right then. “The pharmacy knows if you have been to another pharmacy and tried to get the same prescription filled twice,” he says. “Under the NCPDP (National Council for Prescription Drug Programs) format, [which is] the electronic format used in a pharmacy, the insurance company is checked for utilization, eligibility, benefits and payments. This all happens in a matter of seconds.

“Can you imagine knowing up front not only if the patient is eligible for Medicare, Medicaid or any other insurance, but also getting paid,” Taylor asks, all in the amount of time it takes to dispense the product? This type of IT change will raise the bar for productivity in HME.

The HME industry has a long way to go to become completely automated and electronic. While other industries are more advanced than HME, the HIPAA transactions and privacy regulations may enable us to get there faster. However, while we wait for our technology to catch up with that of other industries, we must attempt to capitalize on the IT capabilities that are available today. As you increase productivity, you will maintain profitability without having to replace or add staff.

Miriam Lieber is president of Lieber Consulting, specializing in operations management and reimbursement for the home medical equipment industry. She can be reached by e-mail at [email protected] or by phone at 818/789-0670.