What's your risk-reward ratio?

Tuesday, November 23, 2010

PITTSBURGH - medSage Technologies' John Durkee is the first to admit that creating a pre-recorded survey to follow up with oxygen patients by phone wasn't his idea.

"Essentially, whenever medSage comes up with a new program, it's almost always created by a customer's need," said Durkee, vice president of sales. "Rebecca (Olsen, vice president of operations at Oxygen One) pushed for the program and she was the first. Now there's a second provider about to go live and three or four others interested."

Oxygen One began using the survey earlier this year to make sure its oxygen patients are still living at home and still using oxygen at the time it bills Medicare. If that's not the case, the provider can't bill (See story page 17.)

Durkee concedes not all providers believe it's worth it to invest in a program that will help cover their butts in the event of an audit.

"I think everyone has to make their own risk-reward ratio," he said. "I had another provider who looked at it and thought, 'Can I afford to pay the money now vs. a potential risk in the future?' and they decided they didn't want to do it."

Even if that's the case, Durkee says the survey has other benefits, including giving providers a cost-effective way to maintain services in the face of declining Medicare reimbursement.

"Most providers aren't doing the kind of follow up with oxygen patients that they used to do--the visits, the additional phone calls, the respiratory therapists," he said. "I think this sets them way above their competitors."