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Operations

Operational guidance for HME and home health businesses, from inventory and logistics to workflow and efficiency.

  • Make Sure Who You Hire

    Are you routinely checking the OIG’s list of excluded individuals or entities (the LEIE)?
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  • Medicare Turns to Tech to Get Ahead of Fraud

    On July 1, CMS will begin using predictive modeling technology to help fight Medicare fraud, Health and Human Services Secretary Kathleen Sebelius and agency officials announced.
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  • CMS to Hold 5010 Test Day June 15

    In a number of recent notices, CMS reminded that the Version 5010 compliance date — Jan. 1, 2012 — is coming up fast.
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  • E0260 Semi-electric hospital bed with mattress

    This month in our DME MAC comparison, Jurisdiction C barely made it out of the No. 1 spot and has turned over the title to Jurisdiction D for claim denials
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  • Do You Look Like Big Bird?

    Are you ready for that all-important sales call? Are the new business cards in the brief case? Do you have enough brochures for everyone who will be attending the meeting? Do you know exactly where the meeting is and where you intend to park your car? You are almost ready to go once you take that extra step: a quick but serious look in the mirror. That wild and crazy outfit you wore to the beach party on Saturday is just not going to work. The yellow suit may be okay if you want to look like Big Bird, but it may not be appropriate for your meeting with the directors of the new cancer center. The health care industry is a rather conservative environment….
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  • Quality Counts

    When it comes to being successful in the manual wheelchair market, quality is “job one,” to borrow a quote from Ford Motor Co. The quality of products affects the market’s sales, innovations, reimbursement structure — and reputation. Providers should not “chase low-cost products specifically for the sake of money. If they do, they are [providing a disservice to the disabled community] along with creating a more-difficult [reimbursement] environment, which costs society more in the long run,” says John Box, president of Colours in Motion. A Mature Market Why does high quality count for so much in this particular market? Perhaps because there are many opportunities for low-quality products to make it to end-users. “The manual wheelchair market is a mature market that is increasingly becoming…
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  • If Only Products Could Sell Themselves

    Good salespeople always have a place in the home care industry. If the Lord did not see a role for the well-trained salesperson, he would have made products that sell themselves. Anyway, that apparently has not yet happened. While many products come to us in interesting colors and some have unique customer eye appeal, most need a message from the salesperson if they are ever going to leave the warehouse. The product presentation to an interested customer or referral source can focus on any one product element or several. Which of these elements should you include in your presentation, and which should you talk about first? Product Features — Every product comes with a select list of interesting features. These may include the size of…
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  • Keeping Eyes And Ears Open

    All home medical equipment companies brag and sell themselves on providing “quality services.” But do they really meet their claims? Quality is often the little things HME providers do that seem routine. Routine assessments of both the home environment and the patient’s use of equipment will not only assure quality patient services but may also reduce the company’s liability, should something go wrong. While such assessments can be used for all patients, they can be particularly helpful with patients undergoing various types of respiratory therapy. Each time a representative of your HME organization goes into a patient’s home, he or she should review both the environment and the patient for three important issues: Whether it’s on follow-up service visits or just during delivery of supplies,…
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  • Respiratory Update

    While respiratory manufacturers and providers face many legislative and regulatory issues, none has had as much impact as the changes included in the Medicare Modernization Act (MMA). These include changes in the payment formula for respiratory drugs; special Federal Employees Health Benefits Plan (FEHBP) pricing for certain types of durable medical equipment such as oxygen and oxygen equipment; a transitional freeze on DME rates; and competitive bidding. However, as the government implements these provisions of the law, the respiratory community has banded together to advocate against them to Congress and the Centers for Medicare and Medicaid Services (CMS). CHANGES IN THE PAYMENT FORMULA FOR RESPIRATORY DRUGS Beginning in 2005, the payment formula for respiratory drugs will switch from the current 80 percent of the average…
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  • A Little Bit Country

    There is an old-timey, sure-‘nuf country store just down the road from my house. It’s a real delight, especially because I live in a crowded suburb not far from the heart of downtown Atlanta. Along with fresh summer produce, the tiny enterprise carries those old-fashioned, sugary peppermint sticks, pots of blooming flowers, mile-high cakes made from Grandma’s recipes and even genuine Moon pies. On most days there’s a big iron pot of peanuts (a favorite snack of Southerners) boiling over a fire outside. The store also has a particular specialty that is great fun to peruse — hot sauce. One rustic wall is filled with hundreds of little bottles that have names like Scorned Woman, Meltdown, Liquid Ax — Cuts Even the Toughest Taste Buds,…
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  • Banking on the Status Quo

    The seating and positioning market is … pick one: growing, slowing, both, neither. Perhaps more than any other market in the durable medical equipment industry, the prognosis for the health of the seating and positioning market most closely mirrors that for the entire industry. On one hand, growth factors for DME and seating and positioning are in plain view. The population of potential end users is booming, manufacturers are introducing better and more cost-effective products and the federal government has authorized several long-awaited improvements, including new, more specific HCPCS codes for many seating and positioning products. “The marketplace for all DME products is growing tremendously,” says Steve Schlegel, product manager for seating and positioning for Invacare. “Looking at the exceptionally large population of people getting…
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  • Don’t Lead by Memo

    The smart way to train personnel to behave compliantly is not to focus on teaching the laws, regulations and reimbursement policies — the “Rules.” Rather, the second rung of the ROPE Ladder urges you to teach staff how to comply with your company’s day-to-day operational policies and then to make sure that those procedures already address the Rules. While the government requires that you have compliant policies and procedures, you are not required to teach or learn hundreds of pages of regulatory rules. To engender trust in your system’s ability to operate compliantly, one of the secrets of effective compliance training is to avoid leading by memo. Leadership by memo occurs when management sends out memos crafted as orders or ultimatums that warn of severe…
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