Atlanta Soon after Dallas-based Affiliated Computer Systems (ACS) took over HIPAA-compliant electronic processing of Georgia Medicaid claims last year, massive payment processing difficulties ensued — and today the problem still isn’t resolved, according to the Georgia Association of Medical Equipment Services (GAMES). Since last April, Medicaid reimbursements have followed a complicated prospective payment system, said Jason Rogers, GAMES president and vice president of Athens, Ga.-based Care Medical. ACS paid providers a weekly amount based on an average of payments they received during the 12 weeks before April 1, 2003. Earlier this year, the state “stopped paying the prospective payments despite [the fact that current] claim payments were not up [to] previous levels,” Rogers said. He said the state is now withholding half the amount of…

Civic engagement is the cornerstone of our society. A 20th century politician once said, “there can be no daily democracy without daily citizenship.” However, for those of us in the home care industry, our daily lives are consumed with serving our patients’ needs and meeting the payroll for our employees, and the world in Washington seems far removed from these very important tasks. When you add to that the overwhelming perception of power, influence and money in Washington, D.C., it is easy to become ambivalent about your role in democracy and to question your ability to make a difference. I would like to offer another perspective on the HME provider’s role in democracy. Despite the old adage of “politics as usual,” the political landscape in…

Documentation, reporting, tracking — all items on the salesperson’s “I don’t want to do list.” Just getting a salesperson to complete a weekly call report is a challenge for most managers. They just don’t want to do the paperwork! But the need for completing a comprehensive account assessment is vital to understanding your accounts and tracking the progress of these relationships. As you develop each account assessment, include these 10 basic items: Account assessments must be a work in progress, and these items are only the beginning. You should also include other information, such as tracking the payment sources for the services your client provides. These may be the same financial sources you will need to use for payment for your products. Note any new…

Competition among providers is offering professional referral sources increasing choices, so you should anticipate the concerns of case managers, social workers and continuing care coordinators who are looking for the ideal place to send patients. By helping these sources make appropriate decisions for their clients, you will attract and keep their attention. Ask yourself, for instance, why a social worker should call you. What difference do you make in the lives of particular clients with specific medical problems? Can you qualify your difference from all others in your community? Hospitals, rehab centers and pharmaceutical companies are becoming involved in understanding and tracking outcomes. Now it is our turn to develop outcome information that can be used as a selling and marketing tool, surpassing those mugs…

If obesity were a virus, we would be facing a modern-day plague. As I was driving to work the other day, a commentator on the radio announced that 68 percent of the American public is overweight, which makes me wonder, is being overweight a reflection of the times? Sometimes I get the feeling we are a nation of hedonists, and the only comfort we seek is self-gratification. I love reading that the fast food entrepreneurs are responsible. Are they? They aren’t taking people by the hand and dragging them in for their hamburgers, chicken sandwiches, fries and other inexpensive gastronomical delights. They are merchants, same as you, and they are only filling a niche. As a DME dealer interested in the welfare of your clientele,…

About 25 years ago, I would set sail into the murky backwaters of the Louisiana bayou to satisfy an unusual culinary habit. A fearless frog hunter, I sat in the front of the boat with a spotlight while someone else drove. The spotlight reflected brightly off the throat and belly of a frog. As long as the light was in its eyes, it wouldn’t move, even as the sound of the motor got closer. When we were in reach, it was easy to grab the frog with one hand while shinning the light in its eyes with the other. Frogs react to light in much the same way that providers who concentrate on K0011 sales reacted to the so-called clarification of power wheelchair reimbursement. Some…

There are several essential steps for home care businesses to take in order to get ready for working under provisions of the Medicare Prescription Drug, Improvement and Modernization Act (MMA). Whether these preparations will be a re-evaluation of standard procedures providers already have in place or something entirely new, they are essential for continuing success in the changed environment of HME. Reward employees for finding better ways to bill, deliver, warehouse and receive, etc. The corporate culture needs to reward those who take appropriate risks, even if they fail, especially when the failure provides a valuable lesson. Wallace Weeks is founder and president of The Weeks Group Inc., a Melbourne, Fla.-based strategy consulting firm. He can be reached at 321/752-4514 or by e-mail at [email protected].