Daniel A. Kohler, (left) account executive at Custom Medical Solutions, and Kelly Lee, director of bariatrics.

Good business is more than offering a superior product at a competitive price. It is also a question of connecting with customers and building relationships with them. Kelly Lee, director of bariatrics at Custom Medical Solutions (CMS), Post Falls, Idaho, has learned this first hand. A former bariatric patient himself—who lost 300 pounds after undergoing gastric bypass surgery—Lee has used his personal experience to help build a strong bariatric customer base. “One of the advantages [my experience] gives is an understanding that I try to share with the people in my company of how these people see life, and how they feel when you interact with them. We have to understand what these patients have gone through in their lives and the prejudice against obesity that they have seen all their life,” he says. “And for no reason do we allow the patient to experience any of that from us. In other words, we have to be sensitive not only to equipment needs but the emotional needs of our patients. And it really makes for a much happier patient outcome.”

CMS, which has offices across the country, operates a five-person operation in Post Falls, serving the region surrounding the Idaho town, overlapping its territory with its office in Spokane, Wash. Like Lee, who was a paramedic, most of the CMS employees have a medical background, which, he says, explains their level of dedication. “We understand that people don’t stop getting sick on weekends and holidays, and we know that when the phone rings, we roll. It’s just a simple fact that if the facilities or patients need equipment, they need it now, they don’t need to wait,” he says. “Everyone who works in this company is dedicated to this level of service.”

The company has no showrooms, relying instead on referrals and its sales force. Lee and his colleagues go to their clients, meeting with them in their hospital rooms or homes. “These are not your typical patients who would get up and go to your showrooms and take a look at equipment,” says Lee who likens these visits to old-fashioned house calls. “We really do have to get out and take care of these patients in their environment.”

Custom Medical Solutions has no showrooms, relying instead on 24x7 service (often visiting clients at their homes and hospital rooms) to generate referrals.

These house calls are necessary not only to help build a relationship with the patients, but also to make sure that the equipment CMS provides works in the patient’s environment. Fitting equipment involves taking numerous measurements of both the patient and their residence, such as the width of door frames. The bottom line for Lee is less about money and more about serving the needs of the patient—which has positive financial implications for CMS. “It would be easy to sometimes give the patient the incorrect piece of equipment, but if you did that you would not only have unhappy patients, but you can have wound care issues from pressure and so forth. And those are things that patients don’t need to complicate their lives,” he says. “We firmly believe in making sure the patient is taken care of the first time. That means doing a lot of your homework ahead of time.”

Lee knows the consequences of using equipment that does not fit correctly. As a bariatric patient, Lee received a bed that was far from comfortable or useful to his recovery. “I weighed 487 pounds when I had surgery, and there was not a bed in the world that I was comfortable on,” he says. “Bed systems were not designed for bariatric patients. Even if a bariatric patient had wound care problems, they would put him on air beds. That technology does not work well in the bariatric world.”

Lee adds that this has changed since he was a patient. “In just the last 2 to 3 years, there has been a lot of advancements in bariatric equipment,” he says. “In the end what it does is help the patient. We got in health care to help patients.”

Lee’s patients, however, will not have to go through the same discomfort he faced. CMS recently developed a bariatric surgery and recovery bed, which was designed specifically to meet the needs of patients and medical personnel. “A lot of the products we are developing in this industry, and that I have been involved in developing, came not from an idea that ‘hey, this going to make money,’ [but] from the ideas given to me by patients, by nurses, by doctors,” says Lee. “We have a new surgery and recovery bed that we are very proud of, and that is exactly how that product was developed—with the input of a lot of people.”

The combination of CMS’ commitment to research and development, training, and providing superior care is what makes it unique in the HME field, says Lee. “It has been an absolutely incredible experience to work with a company that has the foresight and compassion to go out and spend the money on research and development—and take the time to train their people, so we are giving the absolute best customer service to all of our patients. It is a refreshing thing to work with a company that is that dedicated to patient care,” he says.

When Lee was a bariatric patient himself, he says there was “not a bed in the world I was comfortable on.” Recent bariatric product advances now offer far more options.

The level of service—which Lee says is available 24 hours a day 365 days a year—and compassion available from CMS gives the company a distinct advantage over its competitors. “Before Custom Medical, I worked for a very large home health care company that did deal with bariatric products as well. And the sensitivity training and the emphasis on the company that we at Custom Medical are very much into were not something that was pushed with the other company,” says Lee.

Billing Woes
Even with the advantages that CMS brings to its customers, the company has had its challenges. Billing is probably the biggest headache that CMS and other companies specializing in bariatric products face. Lee says the biggest billing mistake providers of bariatric equipment make is not getting the right equipment to patients. “You can bill correctly all day long, but if you’re giving [patients] the wrong equipment and it’s coming back, it turns into a nightmare as far as billing is concerned,” he says. “It is a lot easier to go out there and make sure the first time that you are getting the right equipment for the patient, and that you are billing for the right equipment. It makes for a lot smoother program.”

CMS solved its own billing problems by bringing in bariatric billing specialists. “You take someone with the right experience and the passion for doing it, then [you will] have very positive outcomes with it,” says Lee. “I guess that’s just the secret of having that experience, and the people that we employ to do that have years of experience in the bariatric market as far as insurance.”

Having the billing specialists on-site has benefited the patients as well as CMS. “These people have done [billing] for so many years that they know the approval steps, they know exactly what is necessary to get the approvals for these patients,” says Lee. “And, honestly, they know what hoops to jump through.”

Helping CMS even more is the recent designation by the federal government of obesity as a disease. “The US government making a decision finally that obesity is a disease [will make] insurance companies, hopefully, and Medicare and Medicaid more accepting of obesity treatments, so they can be paid for,” says Lee. “It’s great for companies like [CMS], but the best part is that it’s great for the patient.” According to a 2000 survey by the American Obesity Association, about 35% of US adults are obese, with about 4% of that group categorized as severely obese.

Lee sees CMS as part of the continuum of care for its obese patients—some of whom, unlike Lee, are unable to have gastric bypass surgery—and is passionate about spreading the word about the needs of the bariatric patient.

Evangelizing Across the Country
Lee travels the country addressing physicians and support groups about bariatric issues. With his physician groups, he also helps to train them in ways to best assist this rising population of patients. Though many of the physicians need his expertise in helping their bariatric patients, one thing that they do not need are lessons in sensitivity. “Ther have been a lot of eyes opened in the last few years—and people have definitely become a lot more receptive,” he says.

Lee’s passion is palpable, and it is obvious why his audiences and his patients trust him. He sees his work at CMS as one of those rare opportunities where he can make a living off his passion and help people at the same time. “It’s a great gift to be able to have a job that you can go out and exercise your passion in life. This is definitely my passion in life,” he says.

C.A. Wolski is associate editor of Dealer/ Provider.