HME News

AUG 2018

HME News is the monthly business newspaper for home medical equipment providers. This controlled circulation publication reaches 17,100 home medical equipment services providers, including traditional HME dealers & suppliers, hospital- and pharmacy-o

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Smart Talk 8 / august 2018 / hme news billing online learning m& a patient collections p repare by self-auditing By Ronda Buh R meste R Q. a recent oig report discussed replacement cpap supplies that do not comply with the m edicare guidelines. What is the correct documentation to collect? a . Don't take for granted the doc- umentation requirements for refill requests. CPAP supplies fall under the non-consumable guidelines, which are more durable requiring periodic replacement. Refills can- not be dispensed automatically; there needs to be communica- tion with the patient to assess the need and must be documented, making sure each requested item is being addressed. The request must include the patient's name (or authorized person); date of request; and description of each item: non-consumable supplies assess why each item is no longer functional (CPAP mask broken, humidifier chamber leaking). Is there a valid detailed writ- ten order (DWO)? Most state laws require an annual order for o bserve, reflect, make By B R ie Cohen-Vla C h Q. How can i keep healthcare education engaging? a . Have you ever sat through a tedious online course that was full of text-filled PowerPoint slides, with a person reading word for word what's on the slide? How much of that content do you remember? At Pediatric Home Service, we work hard to create engaging edu- cation. Here are some of our best practices to keep nurses and fami- lies engaged. o nline clinical education Our online courses have a lab component. The lab is completely hands-on because all of the pre- work is done online. To keep learn- ers engaged online, we: 4 Thoughtfully use animation and movement to keep learner's eyes active. 4 Show demonstration videos with real patients. 4 Incorporate meaningful inter- t rain, then communicate By Jennife R l eon Q. How do i communicate my new card on file policy? a . Once you've decided to imple- ment a card on file payment meth- od, and you've begun changing internal processes, the next step should be to communicate this policy—the key in developing a successful automatic payment program. Below are three ways to ensure successful communication. c onduct proper training internally Once you develop an internal policy, you must first communi- cate that policy company-wide. Designate the key staff members and use them to lead the rest of the team. Develop useful tools to implement the new policy, and train staff on how to have finan- cial conversations up front with patients. Your staff will ultimately be the ones accountable for carry- ing out the policy. s end notices via patient communication externally Next, develop an external policy b e thorough, thoughtful By Jonathan s ado C k Q. i am interested in acquiring an H me business. How do i find a good business and what should i do to assess the opportunity? a . Start your search by devel- oping an acquisition profile and financing strategy. The profile should determine the business model you are most interested in acquiring. The financing strategy will determine the size and valuation of a business you are able to afford. Recent sales of similar businesses will give you some insight into current market valuations. While some comparable sales data may be found on the Internet, many transactions are private and terms not disclosed. An experi- enced M&A advisory can often be a valued resource to ascertain valuation metrics or perform a formal valuation. Are you considering special- izing in a particular therapy, such as sleep, rehab, oxygen or general medical supply? Do you want to participate as a provider to Medicare, Medicaid and/or third-party insurance patients? Do the growing retail markets interest you? These are all areas supply-type items. It's highly rec- ommended to get an order annu- ally to meet both the state law and continued medical need require- ments. The DWO also needs the frequency of refills for each item, i.e., nasal mask once every three months, tubing once every six months, etc. When a patient walks into the store make sure the proof of deliv- ery lists the store address as the delivery address or has an indica- tor that it was picked up in the store. If this is not done, the POD appears as though it was a deliv- ery/shipment to the home. When a delivery service is being used, a tracking number is created. The records must link the shipping invoice to the confir- mation of delivery from the ship- ping service. The confirmation of delivery is just part of the proof of delivery that will be requested in an audit. The shipping services DO NOT store these confirma- tions. There will be more audits on CPAP supplies. Be prepared by doing self-audits looking for cor- rect documentation. hme Ronda Buhrmester is director of reim- bursement for The VGM Group. Reach her at activity. We use games, drag and drop activities, and real life scenar- ios. We allow learners to click on words for a definition and down- load handouts. 4 Give learners opportunities to engage online with discussion forums and live instructor video chats. 4 Divide the course into modules by sub-topic, and keep each module under 15 minutes. v ideos Keep the length only as long as it needs to be and stick to the objec- tive. It can be easy to lose learners by making videos unnecessarily long. We try to keep videos under five minutes if possible. Film the videos with real people, if you can. We use mannequins if we have to, but if we're able to use a patient, we take it! Plan ahead. We map out exactly what we want to show and say using a sto- ryboard. This keeps the video pro- fessional and to the point. Our education team incorporates The Loop, a design-thinking model we learned from IBM, to design engaging education.It's a continu- ous cycle of three parts: observing, reflecting and making. I invite you to check it out and apply it to your own practice! hme Brie Cohen Vlach is education supervi- sor at Pediatric Home Service. Reach her at bgcohenvlach@pediatrichomeser- for patient financial responsibility, and then communicate that policy to patients. Multiple methods can be used such as flyers, letters, email and web announcements. Help patients understand this new pro- cess and inform them of the ben- efits, such as the ease and conve- nience, savings on postage, etc. c ommunicate with referring physicians Finally, it is important to have conversations with your refer- ral sources, advising them of your new policy—the earlier, the better. You can communicate the new card on file program to referring physicians either with a face-to-face meeting or a phone call. Remember they are collect- ing their co-pays upfront so why wouldn't you. By notifying your referrals, you enhance the patient- provider experience and create an ideal billing experience for every- one involved. By developing training for inter- nal staff and communicating new guidelines with both patients and referral sources, you will ensure a successful transition to your new card on file policy. hme Jennifer Leon is vice president, patient collections, at Brightree. Reach her at that should be included in your acquisition profile. Remember to maintain an open mind to other entrepreneurial oppor- tunities you might find during your search. An Internet search is a good starting place to begin research- ing available opportunities. Biz-, and some M&A advisories publish acquisition opportunities on- line. Contact investment banks and business brokers that spe- cialize in the HME sector and inquire about available oppor- tunities that match your acqui- sition profile and financing availability. They often publish articles about various business- es and may help you identify one of specific interest. Don't be shy in your search. Reach out to business owners directly to let them know about your inter- est. Ask people you may know in the industry for references. A s s e s s i n g a n a c q u i s i t i o n opportunity requires thorough and thoughtful consideration. Initially you want to understand the business model, its histori- cal financial performance and current trajectory. When you find something of interest, engage and commu- nicate with the seller or their advisers. hme Jonathan Sadock is managing part- ner at Paragon Ventures. Reach him at Our education team incorporates The Loop, a design-thinking model we learned from IBM, to design engaging education. It's a continuous cycle of three parts: observing, reflecting and making. stark law c O n T I n u e d f r O M pa g e 3 "When you are hiring, hire inno- vative thinkers to respond to the ridiculousness that comes from the federal government," said Johnson. s pend and demand, just not from m edicare Demand for HME is projected to grow about 6% annually over the next several years, and the total HME spend is projected to be nearly 30% higher in 2022 than in 2017, Mark Higley, vice president of regulatory affairs for VGM, told attendees. But Medicare will shrink as a portion of that, while Medicaid, pri- vate insurance and out-of-pocket will increase, he said. "You're diversifying and Medi- care is paying you less each year," he said. "The cash market will go from $30 billion to $45 billion. m edicare irks Until that shift happens, however, Medicare and its challenges remain top of mind. During an SBA/CMS panel discussion, attendees aired a laundry list of familiar complaints, including, of course, the competi- tive bidding program. "Who's going to call a provider in Alabama for a bed in Massachu- setts," said one provider. "We are renting more beds now than when we had a contract for." Tangita Daramola, CMS Com- petitive Bidding Acquisition Ombudsman, acknowledged there are problems with the program and encouraged pro- viders to contact the Competi- tive Bidding Implementation Contractor. hme there's a real benefit to the health- care system if Mr. Smith doesn't have to leave the office to, for example, have blood drawn. That exception applies to almost every- thing—except DME. hme : So hypothetically, what might be a scenario that would be OK under a more relaxed law? Baird: Let's say a physician wants to put together an integrated practice that includes an MD, a PT and an OT, and a DME. So you have this integrated practice owned by vari- ous people. Right now, you can't do that because 1.) the physician has to own 100%, and 2.) it can't involve DME. But that's something that could become OK. hme : That's great news for the DME included in the integrated practice, but not so good news for all the other providers. Baird: That's tough—loosening the Stark Law could be a double-edged sword. It may increase efficiency, but it may decrease competition. It's going to be an ongoing conflict and debate, a natural tug-of-war as a result of the push toward coordi- nated care. hme heartland c O n T I n u e d f r O M pa g e 3

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