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
by Miriam Lieber

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 mlieber@pacbell.net or by phone at 818/789-0670.