Employees deliver new system

Thursday, April 30, 2009

RICHMOND, Va.--When mail order provider Home Care Delivered sought a new payer management system, it shopped around. Unsatisfied, it called in the big guns to create its own system: its employees.

“We looked at every system out there and although there were some pretty good systems, nothing met our needs,” said CEO Carol Muratore. “So, everybody brainstormed - billing, compliance, customer service and IT. We looked through every single payer and asked ‘What are the different variables that could crop up?’”

The result is PayerPro, which launched in March. The new system enables Home Care Delivered to seamlessly manage the unique billing requirements for each of its 300 routine payers, including Medicaid, Medicare, and private and secondary insurances.

The system knows how to manage, for example, young patients who have different documentation requirements.

“Under age 18 or 21, when you exceed quantity limits for certain products, you have to get a prior authorization,” said Lauren Coiner, vice president and corporate compliance officer. “We wanted to make sure the system would automatically trigger the need for the prior authorization rather than someone having to remember that.”

PayerPro works like an “iron gate,” said Muratore. If any information is missing, the order can’t ship.

“Imagine the positive impact it will have on our accounts receivable to have every order completed accurately before it can go,” she said. “There’s a quality assurance process, as well, and it will get more automated as we go along.”

The new system allows the company to spend less time on the phone talking about paperwork and more time talking about what matters most - patients’ questions and concerns.

“What we prefer to do on the call is spend that time giving patients whatever support they need,” said Muratore.