Using APCS can boost provider service as well as profitability
by Nyika Wright

If you own a retail store or are considering opening a new retail location, there are a variety of challenges to be considered, including location, physical building space, inventory assortment, fixtures, store operations and financial accounting aspects. The decisions pertaining to each of these challenges are extremely important to the success and profitability of the business. However, for this segment, the focus will be on physical retail space, proper store fixturing and how to develop a successful retail atmosphere to support the inventory assortment. Using an automated patient contact service (APCS) can increase resupply for an HME/DME provider 45 to 85 percent. Automation allows today's new technology to actively engage all patient demographics from pediatrics to the elderly. APCSs use various means to reach patients of their clients, the HME/DME providers. These means include industry termed "robocalls", truly interactive voice response (IVR), text messaging, emails, a patient portal, or even through a live-call center. Having a variety of options increases the success of patient engagement. An engaged patient is not only a compliant patient, but also a loyal patient. Patient loyalty turns into patient retention. Patient retention is the number one source of replenishment revenue. Providers can expect a significant ROI with use of an APCS. The services of the APCS allow for more streamlined, hands-off processes for the HME/DME provider, so that their staff can focus on more specific patient needs: triaging notifications in the APCS system, answering billing and collections questions, handling walk-in patients and coordinating technician visits. The automated and efficient processes presented by the APCS actually lower labor costs for the provider while still increasing patient engagement. When combined with integrated solutions such as patient management software and fulfillment services, that ROI grows exponentially. Statistics show that engaging patients in this manner leads to higher patient-retention rates. Patients not only feel better-connected, but also have a sense of being more informed about their disease and how best to manage it. Educating patients on the APCS at set up creates a reassured and compliant patient. A compliant patient with the reassurance that their provider is cognizant of their immediate needs tends to replenish disposable supplies regularly. APCS is not just a CPAP business any more. Campaigns can consist of treatment follow-ups, compliance surveys and replenishment generation. Some vendors offer campaigns for upselling such as supplemental products, scheduling for delivery and maintenance and even collections calls. In fact, in order to ensure a maximized ROI, the HME/DME provider should make certain to select a service which will cater to the needs of that specific provider. This is done by working hand-in-hand during implementation and throughout the lifespan of each campaign with the APCS. The service will provide industry-proven suggestions for each requirement of the HME/DME provider. This is not only true for campaign type, but also for product line. When browsing services, verify that the APCS will service not only your PAP lines, but also your oxygen and other products. Product lines for some APCSs range from ortho, to incontinence, and everything in between. Most APCSs are affiliated with a fulfillment service of some sort. In order to take full advantage of the automation available via these integrations, a provider wants to ask the following questions of the APCS:

  1. Are you integrated with my current fulfillment service?
  2. If not, are you willing to stream data with my current fulfillment service?
  3. Will you populate data back to me for in-house warehousing?
  4. Are you integrated with any fulfillment service for nonrespiratory product lines?
  5. What information do you exchange with the fulfillment service, and how do I get it back?
  6. Is the data sync appropriate for your schedule?
  7. Are secure transfer methods observed?
  8. Is there a business associate agreement in place for HIPAA compliance?

With the ever-evolving mandates of both CMS and commercial payers, providers need an APCS that keeps up. First, being ahead-of-the-game by conforming to CMS guidelines prior to mandate instead of trying to catch up their services after it is required for the provider. Secondly, the solution should allow for the need of the targeted patient population—a busy mom filling out a survey for her child's nebulizer, a geriatric patient who needs a live person to speak slowly regarding their oxygen follow up, or the busy professional who wants a text as a reminder to refill PAP supplies. The solution should also have some interoperability with an objective compliance platform. While collecting subjective compliance data from a patient is critical, payers are progressing by demanding objective data and proven compliance for reimbursement. The connectivity of an APCS with a compliance platform is essential for this developing trend. Ask what data is shared, and what reporting features are available for the provider. Industry examples are:

  1. 3B Medical and CMB Solutions
  2. Resmed and Brightree
  3. Respironics and Medsage

As previously alluded to, a compliant patient is one in which has the tools for managing their disease, no matter how rudimentary their knowledge of the disease. The provider wants to choose an APCS that has the solution to inquire from the patient their level of understanding, allow the patient to stay appropriately informed, and have access to applicable resources. Resources range from the provider itself who is notified by the APCS after patient inquiry to affiliation with a collaborative community such as The industry affiliations presented by the APCS should also be considered during your selection process. Is the APCS a partner or sponsor of your buying group? Will you receive a discount on services with your membership of that buying group? Are they a sponsor of the American Association for Homecare? Lastly, consideration should be given to data migration with your patient management software. Is the potential APCS integrated with your current software? If not, will they integrate with it? How and what information is shared? Is it shared securely? With so many factors to consider when considering APCS for the HME/DME provider, there are a few other topics you will find beneficial:

  1. Are the IVR calls truly interactive, or are they simple "robocalls?"
  2. Is there a live-call center, and is it domestic?
  3. Are reports outcome-based, parameter-enabled, real-time?
  4. If a report is not developed, can it be, and is there a charge?
  5. In the interim, how can I access that request report data?
  6. Is the system cloud-based and notifications real-time?
  7. Are calls recorded and the recordings accessible?
  8. Do I have to log into the system to get notifications?
  9. Can I access compliance reporting from the APCS?
  10. Is insurance eligibility confirmed for orders?
  11. What if a patient is in collections?
  12. Can a patient pay for balances through the service and are payment arrangements feasible?
  13. Are services outsourced to other companies or overseas?
  14. How are end users educated?
  15. What is the cost for support after implementation?

At Medtrade 2014 in Atlanta, Peter Allen of CMB Solutions presented an in-depth program entitled "Automating Treatment, Compliance and Resupply Programs" that is accessible via Medtrade's website. The HME/DME providers were the target audience as they found this presentation offered them a better understanding of the role that automation plays in their business, what industry options are available, and the criteria to address when choosing a vendor. Peter stressed choosing a vendor that:

  • works with you by listening to your goals
  • has a strong management team
  • has the flexibility to integrate and customize features

Mostly, ensure that a vendor's strengths are in line with your goals. Pay attention to how the vendor perceives your relationship. Ensure they offer you access to the appropriate contacts throughout set up and for support moving forward.