HME News

SEP 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 / september 2018 / hme news billing online learning m& a patient collections m eet all requirements By Ronda Buh R meste R Q. c an there be a review on continued medical need vs. continued use and the requirements? a . For ongoing supplies and rented DME items, in addition to information justify- ing the initial need of the items and/or supplies, there must be information in the medical record to support that the item continues to remain medically necessary. Suppliers are responsible for monitoring utilization of rental items and supplies. Timely documentation is within the pre- ceding 12 months. Keep the following requirements in mind. c ontinued m edical n eed 4 Recent order by the treating physician for refills 4 Recent change in prescription 4 Properly completed CMN/DIF with an appropriate length of need specified 4 Documentation in the beneficiary's medical record showing usage c ontinued u se Fine-tune where needed By Jennife R Leon Q. How do i maintain the momentum with my new card on file policy? a . The essential techniques for an effec- tive automatic payment program include: establishing, preparing, communicating and lastly—maintaining. You must continue to uphold the changes to your billing plan and strive to create an ideal billing experi- ence. Below are three ways to maintain the momentum. h old staff accountable, and continue training You must hold staff accountable for carry- ing out the policy on a daily basis. Policies and procedures are an essential part of any organization, and they provide a roadmap for day-to-day operations. By continuing educa- tion and training, you can ensure all staff are compliant with regulations. c onsistently monitor the progress, and tweak as needed This is not a "set it and forget it" strategy. You must consistently monitor the progress and tweak as needed. Using reporting tools like dashboards is crucial; you must set tar- get goals and recognize achievement where you see it. Implementing, and maintaining, a "card on file" policy requires a rock-solid plan that's able to be fine-tuned where needed for maximum efficiency. h ave an open channel of communication with your staff You must have an open channel of com- munication with your staff. Inform them of the why behind the new policy, and how to communicate that to patients. It's impor- tant to perform weekly and monthly staff check-ins to monitor progress and areas for improvement. hme Jennifer Leon is vice president, patient collections, at Brightree. Reach her at m ake it top-notch By B R ie Cohen-V L a C h Q. How do we justify spending money on education resources? a . The foundation of Pediatric Home Ser- vice is education. We spend money to ensure we have high quality education. employee e ducation Turning our classroom education into an online experience has been costly, but we've seen huge benefits. Our staff can take our online education anytime, anywhere. There is no time delay and an employee can do it all on their own. Our clinicians can take a course or refresh themselves imme- diately, instead of waiting for a classroom session. And with our complex patient population requiring access to care 24/7, this immediate access is so valuable. We make sure participants understand the why, so when they are doing bedside care, they are doing things the safest way, and not taking shortcuts. We incorporate videos with real patients, animations, interactive knowledge checks, and other resources to make the content stick and keep our clini- cians engaged in what they are learning. p atient e ducation Our how-to videos and written patient edu- cation is written in plain language, making it easy for families to understand. Going the extra step to create visual and clear education not only helps our families suc- ceed, but helps to decrease troubleshoot- ing calls. While the financials of spending money and time on high quality education are not always directly tangible, we know we do the right thing to support taking care of the patient. hme Brie Cohen Vlach is education supervisor at Pediatric Home Service. Reach her at bgcohenv- l ook beyond dollar signs By Jonathan s ado C k Q. How should i vet each offer i received to determine which to accept? a . It may surprise you to learn that many times a high offered price is not always the best deal. Many other factors must be con- sidered before accepting an offer. The structure of each proposed offer is also a vital consideration. Is the offer a stock/membership sale or the acquisition of assets? Each carries different opportu- nities and challenges. Many offers include other components besides cash at closing. They may include a hold-back amount for representations and warranties associated with the transaction. There may be notes, stock, assumptions of liabilities and some assets that may be excluded from the sale. Most transactions that close have a sound and realistic strategy behind them. Just as you have a strategy to sell the busi- 4 Refill requests 4 Supplier records documenting benefi- ciary confirmation of use 4 Delivery ticket showing refill of sup- plies, maintenance on equipment, or repairs Monitoring of purchased items or capped rental items that have converted to a pur- chase is not required. Suppliers must dis- continue billing Medicare when rental items or ongoing supply items are no longer being used. Obtaining the proper medical records from the treating practitioner offers its own challenges. More than likely, DME will not be mentioned. One way to obtain the doc- umentation is by collaborating with hos- pitals and physicians to implement DME into the EHR. Whether DME is listed in the medication list or another area could serve as a reminder to address the contin- ued need. There are many states that have laws requiring annual orders on supply type items and some DME items. Obtaining an annual order will help meet both the state law and continued medical need requirements. hme Ronda Buhrmester is director of reimburse- ment for The VGM Group. Reach her at ronda. ness, you need to understand the buyer's motivation for the acquisition. If the offer comes from a strategic buyer (not a finan- cial investor or sponsor) you need to assess how that buyer's strategy integrates with yours. Identify where synergies exist that can enhance the strength of the business, its growth trajectory and profitability post- closing. If it is a financial investor, you need to crunch the numbers to determine if the offered price fits appropriately into the financial model they are pursing. If you are retaining equity in the transaction, it is also important to understand how your business balance sheet will look on the day after closing. Many financial buyers lever- age the transaction to minimize the amount of cash needed at closing. That leverage (debt) usually sits on the balance sheet and is repaid by the on-going cash flow of the business. Your retained equity is essentially being reinvested back into the company, so you need to be aware of the risks and rewards of the investment. hme Jonathan Sadock is managing partner at Paragon Ventures. Reach him at jsadock@paragonven- medtrade booth 1438

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