Re-supply redux

Things just got more complicated for vendors, too
Friday, July 6, 2012

YARMOUTH, Maine – Vendors that help home medical equipment providers automate their re-supply businesses are re-tooling their systems in the wake of a huge policy change by Medicare.

These automated patient contact systems use interactive voice response (IVR), live calling, emails or texts to notify beneficiaries that they’re eligible for new CPAP masks and other supplies, and to take orders for refills. Now, they must dig deeper and find out, first, if the existing supplies are no longer functioning.

“There will be changes that need to be made in how we facilitate interaction between providers and patients,” said Tim Murphy, general manager, Services & New Business Ventures, Philips Respironics, which owns medSage Technologies. “This is a significant change and we will have to work through it.”

The problem: Many vendors are waiting for Medicare to clarify a few things. For example, what does it mean by no longer functioning; how does it want providers to interact with patients to determine if supplies are no longer functioning; and what kind of documentation does it want to substantiate refills?

CPAPDropShip, which uses live callers exclusively, has already re-tooled its system to include questions like, Is your filter discolored and does it have dust particles? The answers, selected by callers from drop-down menus, will then be stored in the beneficiary’s clinical record and will be available for the provider to print out in the event of an audit.

“It’s the same process—it’s just now we have to go a step further,” said Jason Holzman, general manager.

CMB Solutions, which uses a mix of patient contact methods, predicts that the policy change will put more emphasis on live calling, which it believes is more suitable than IVR for more in-depth contact.

“So one of the things that we’re going to talk to our customers about is, do we need to shift more to live calling where we have a sleep coach that reaches out to patients and makes sure they understand the new requirement and whether their supplies meet that requirement?” said Phil Sever, CEO.

Whether the change will sour providers on automated patient contact systems and result in reduced demand for these systems—not to mention reduced sales of supplies for providers and manufacturers—is unknown.

“Could it result in patients having different interactions and experiences?” Murphy said. “That potential exists, but to make the leap to lower utilization and replenishment rates—that’s to be seen. We will continue to manage and develop this service.”