Claudia Amortegui

Dealer/Provider (DP): Among HME providers, what is the most common misconception about billing and reimbursement?
Claudia Amortegui (CA): That it is easy. And that once they get paid, providers think they can actually keep their money. Since they think it is so easy, providers hire people that may not be the best qualified for the job. And so we must work on training with them.

D/P: What is the most difficult part of training for these new employees?
CA: All of it. They don’t understand that it is not just filling out a claim form. They need to truly understand medical documentation and everything else—at least when it comes to high-end products. If it’s a cane and a crutch, it’s a different story.

D/P: Can the appropriate software help providers deal with changing power wheelchair codes?
CA: In all honesty, all the software does the same thing. It’s more the person who is using the software that is making sure that once they do have new codes, all software and inventory systems have been updated.

D/P: It sounds like it’s more about the pilot than the plane.
CA: Exactly.

D/P: What should providers avoid when choosing the appropriate software?
CA: For rehab, there is no magical rehab software system. People ask me all the time, but it’s a tough one to answer. Providers need to look at their own needs because there is not one type of software out there that you can say, “Hey, this is great for rehab.” All of them have bonuses, and some of them have pluses and minuses when it comes to inventory or accounting.

D/P: What do you say to providers who are hesitant and/or fearful of trying new methods and software tech-nology?
CA: I say look at what you have and judge what is truly working for you. If the software is not working, take the next step. If it is working, stay with the status quo.

D/P: When helping clients who wish to reduce operating costs, what is the most common problem?
CA: Too much staff. Since they don’t train people appropriately, sometimes they have someone running at 50%, when they could hire someone who is running at 100%. The answer is to train people and choose the best ones out of the group.

D/P: In the next 5 to 10 years, what do you think the reimbursement climate for HME providers will look like?
CA: It’s going to constantly be a moving target. Competitive bidding is going to be there. Codes and policies are going to continually change. The hardest part for dealers is they are trying to run their business and they can’t keep up with all the government changes. I’m getting e-mails every single day about this change or that change. And that is part of the business for us as consultants. We become their experts. We become their one source to look up things. DP