Tracey Brown

In today’s environment of diminishing margins, HME providers can increase efficiency and productivity with the right software. While a properly implemented and appropriate software package can enhance the efficiency of an HME operation, a poorly selected product or inappropriate implementation plan can wreak havoc and even paralyze well-run organizations—resulting in delayed or even lost revenues.

Bill Mallard

Affordability
HME software products offer a variety of features and capabilities and are generally priced accordingly. Feature-rich software products can be expensive, so it is important to assess your business needs (before selecting) to ensure that you neither “under buy” nor “over buy.” Several software vendors offer functions that may not be required or necessary for your business. For instance, if you do not operate a retail storefront, you may not need a point-of-sale system.

When evaluating a software package with the vendor, discuss the possibility of selecting only those features that are currently necessary. Ask about the option to expand features at a later date as the business grows. Flexibility in these options will help contain the initial cost outlay and limit costs to only those features that will actually be used.

Consider the cost associated with implementation of the new software package, including internal project management, staff training, and data conversion requirements. Implementation costs can often exceed the cost of the software itself. Therefore, in the product evaluation it is important to include a review of the vendor’s training and data conversion approach, materials, and associated costs.

Automation
The degree to which any software system automates manual processes will certainly benefit your organization. Remember that the purpose of a new software system is to increase efficiency. Software systems can generate and track work orders, CMNs, and other required forms. Software can automate billing (recurring, electronic, and collections processes), track inventory and inventory maintenance status, and assign tasks to staff members based on the status of an account or order. Although a software system cannot replace employees, it can certainly make their jobs easier by making them more efficient, and allowing them to focus on more difficult tasks (instead of those that can be performed automatically).

To get a realistic assessment of the software’s features during the evaluation process, request that the software vendor provide a comprehensive systems capabilities demonstration that includes a simulation of all day-to-day work processes as they relate to the provider’s work flow.

Customization
Every HME business operates differently; therefore, most off-the-shelf products will not provide every feature necessary to optimally run the business. Some software packages allow a limited number of user-defined fields and attributes necessary to manage their particular business. This assumes that the work flow and fields as defined by the vendor are essentially consistent with the provider’s needs.

However, if the provider has work processes or data requirements that are unique, it may be necessary to identify a software vendor that permits customization of the package—beyond simply user-defined fields and parameters. Such vendors typically allow software modifications for an additional custom programming and ongoing enhanced support fee. Identifying such vendors can often be difficult, largely because ongoing support and upkeep of highly customized programs can be difficult and time-consuming. Such upkeep may distract vendors from supporting customers who use traditional programs.

System Security
The ideal security system allows a system administrator to assign specific system rights and data access by user. This allows an organization to maintain system integrity by limiting access to certain areas of the system and to align system access and functionality by user job responsibility. For instance, delivery personnel may need to review the system for a customer telephone number, but would not need access to the pricing file—so their system rights would be limited.

Report Generation
Most HME software products provide a basic menu of system-generated reports related to sales, inventory, and accounts receivable. These “canned” reports should be carefully reviewed before purchasing the software to determine if they are adequate. Some predefined reports offer users the opportunity to modify or sort the report data based on predefined criteria. Still, other systems allow users to create and generate customized, written reports within the system. User-defined, customized reports are an extremely desirable feature.

Measuring Productivity
Dealers are increasingly forced to find ways to increase staff productivity and efficiency. A system that allows management to track and measure staff and organization performance can be useful in identifying employee knowledge deficiencies, training opportunities, and functional inefficiencies. For example, systems that generate reports on missing information and error rates may help eliminate costly delays in claim processing that are often the result of incomplete data retrieval during order entry. Tracking denials, open claims, day’s sales outstanding, held billing days, outstanding CMNs, inventory turns, open work orders, and collection activity (by employee and organization-wide) all contribute to overall success.

Accounts Receivable Tracking and Management
Successful accounts receivable management is often achieved through software that tracks billing and collections activity not only by customer, but also by payor type (Medicare, Medicaid, private, self-pay). When pondering a software system, consider its potential impact on your collections activity. Many systems can be set up to automatically prompt staff to perform certain accounts receivable-related tasks such as claims resubmissions and consumer follow-up based on predefined work flows. Additionally, system-generated accounts receivable reports can be useful in identifying trends in reimbursement related to problem payors, accounts, or product lines.

Electronic CMNs
Retrieving valid CMNs is among the most difficult tasks that HME organizations encounter. Systems are capable of creating reports and lists of pending medical documentation and can sort the reports by physician, facility, zip code, sales representative, patient, or period of time outstanding. Although nearly all software systems track and store CMNs and CMN data electronically, many software systems now offer the ability to electronically generate and obtain CMNs through an Internet-based solution. This solution offers improved efficiency through a virtually paperless medical documentation retrieval system and could reduce the time and effort typically required to retrieve CMNs. In addition, a system that enhances the management of medical documentation can lower held billing days and improve cash flow.

Electronic Billing
Any system that eliminates the requirement to generate error-prone paper claims is desirable. Make certain that potential vendors can submit electronic claims to your biggest payor sources. For submission of claims, eliminating redundant data entry processes in a separate electronic billing system is important. Also significant is a system that allows a user-defined edit feature that identifies missing and/or required claim information before claim submission. These “pre-edits” allow you to minimize delays in claims processing by the payor due to missing information.

When shopping for a software product, get a vendor client list and contact references. Typically, vendors will only provide a short list of clients for reference. However, an expanded list of clients will enable you to obtain a more honest assessment of the software and software support.

Assessing your business before purchasing a system is important to ensure that the system is adequate for current and future business needs. If you anticipate growth, make sure that your software system will grow as well. The system you purchase should allow you to focus on the tasks that require greater attention and creativity. Ultimately, this new found freedom can enhance efficiency within the organization and eventually lead to long-term savings.

Tracey Brown is senior director of specialized billing services and reimbursement consulting at the Lash Group, a reimbursement consulting firm with locations in Charlotte, NC, and San Francisco. Brown can be reached through the Internet: www.lashgroup.com. 

Bill Mallard is senior program director at the Lash Group.