Survival of the fittest

Friday, December 31, 2004

EVANSVILLE, Ind. - Last fall, Deaconess Home Medical Equipment & Infusion bought a transfilling unit and began filling its own oxygen cylinders. This month, the hospital-owned HME will open a retail location in a local Wal-Mart.

How things have changed.

Several years ago, these types of revenue boosting, cost cutting measures were at best a distant dream. The company faced the double whammy of high staff turnover and a growing AR related to an inability to file clean claims. In many respects, Deaconess’ problems, especially its billing woes, were not unusual, said Michael Barish, president of Ancor Healthcare Consulting, which helped the provider regain its footing.

“Typically, when providers run into problems, they blame their software companies, but a lot of times they don’t have their insurance files set up correctly,” Barish said. “As a result, they are filling out claims information incorrectly, or not producing right CMNs, or their special price files need to be cleaned up.”

With the diagnoses in, Deaconess went to work. The company provided extensive training to billing staff on Medicare and other payers regarding coverage criteria, documentation and claims submission requirements, said Kim Mans, director of home services.

The company also began to take full advantage of its software system. Deaconess started monitoring weekly reports on outstanding prior authorizations and CMNs. Doing so allowed the provider to track and collect these documents in a more expedient manner. Additional reports followed the DSOs of individual billers, allowing problems to be addressed when and where they occurred. Officials also began to examine the productivity of customer service representatives, which let them track work volumes and establish adequate staffing.

The additional employee training and accountability that accompanied these operational improvements boosted morale and decreased turnover from 15% a year before the training began to 3% last year, Mans said.

With Medicare reimbursement cuts scheduled to kick in this month, Deaconess officials view their forays into Wal-Mart and transfilling as necessary efforts to generate new revenue and cut costs. That said, past experience has taught them that the “meat and potatoes” of their success depends on billing and collecting, Mans said.

“You can not take your eye off that ball,” she said. “It is so important that we stay focused, and do what we do well and understand it and collect for our work.”