Today’s software scene is more sophisticated than ever before. With a multitude of vendors and ample products to choose from, the selection process for HME providers can seem overwhelming. But the hard fact is that if you don’t have the right software system in place, you may be losing money. Experts agree that good software can help you improve efficiency, increase profitability, and remain competitive. “It is a lifeline for us,” says Sam Clay, owner of Clay Home Medical, Petersburg, Va. “No matter how good you are at daily operations, if you can’t bill it and collect it—you can’t stay in business.”

Clay Home Medical started using software in the mid 1980s. Today, the company is on its third generation of software—and happily so. “You need software that evolves with the industry,” Clay says.  

Roberta Domos of Redmond, Wash-based Domos HME Consulting Group concurs. “One must-have feature is the ability to print patient-detail accounts receivable aging reports by descending balance,” says Domos. “Nothing eats up more time than a billing and collections specialist working a $50 outstanding balance simply because a patient’s name starts with an ‘A’—especially when Mr Smith’s account shows an outstanding balance in the thousands of dollars.”

With today’s software, providers can work high-dollar accounts first. That puts you in a positive cash flow position, keeping your business on track. But these days, software is made to help you address even more complicated challenges. “With changes in medical criteria, coverage issues, and specific requirements, we need software that gives us more information,” Clay says. The ability to monitor trends and activity-based costing are key issues for today’s providers. For example, software packages can help your organization assess just how much billing is going out versus how much collection is coming in.  Moreover, software can tell you what each function costs to do business.

Great Technology, Great Expectations
“Software should do so much more than just get bills out the door,” Domos says. When choosing software, look for packages that check inventory, provide reports, and offer preventive maintenance functions.

A reporting feature, for example, can help you track patterns on types of denials, so you learn what is working for your business and what is not. “Software helps us analyze mistakes we made and find our weaknesses,” Clay says.

For example, you may find that a particular code is denied more than other codes, such as denials for duplicate equipment. Once you identify the denial patterns, you can educate your staff and do business more efficiently.

Domos, who provides consulting services for HME providers of all sizes, says that big companies will definitely require software with strong reporting tools. But even small businesses can benefit greatly from reporting features. “Business owners want a comprehensive picture of what is going on in their organization,”  Clay says. Today’s software can provide an array of reports on everything from marketing to cash flow, to equipment sales and rentals, to where your referrals are coming from.

Though it costs a little extra, there is a growing demand for customized software. Once you are familiar with a basic system, you may want to add features or make modifications that match your business model. For example, with customized software you can generate reports that are unique to your operation or tailor a patient database according to your specific parameters.

Preventive maintenance is another in-demand feature. Busy providers will benefit from software that tracks where equipment has been and when it was serviced. In the case of Clay Home Medical, the software’s preventive maintenance function helps the company maintain a list of serial numbers on all equipment. This streamlines operations, cuts down on manual labor, and enhances overall efficiency. “Look for a system that lets you set recall periods for equipment that requires routine maintenance and can generate reports that tell you where serialized items due for maintenance are currently located,” Domos says. “You can then incorporate preventive maintenance checks into routine delivery schedules in the same geographical area to cut down on unnecessary trips.”

Record-keeping features like document imaging can save you time and money, too. Clay Home Medical keeps all records in the computer system on a secure server. “The paperwork in this business can be massive,” Clay says. “But with our document imaging software, we reduced paperwork by 95%.”

In addition to saving administrative team time, document scanning can streamline the reimbursement process and cut costs. “It makes the collections process more efficient,” Domos says. “Collections specialists no longer spend time searching through files for the right document. Instead, it can be retrieved from within the patient’s computer file and reprinted on the spot.”

Scanning features go beyond just storing information. One feature Clay finds invaluable is his software’s ability to review claims and scan for missing data. The software detects and identifies incomplete claims before they are submitted for reimbursement. “If you don’t catch mistakes and missing information, the money will be owed to you but payment is held up,” Clay says. “This will negatively affect cash flow.” With this feature, Clay Home Medical sends in clean claims, and that in turn cuts down on human error, reduces redundant work, and ensures prompt payment.

Choosing to Suit Your Business
With a proliferation of software packages on the market, choosing what is right for your business is no easy task.  “First and foremost, look for a vendor that understands your overall business and not just the billing piece,” Domos says.

When researching vendors, you will want to focus on those that provide strong technical support along with a good user manual. Responsive support is key. “Customer support is half the deal,” Clay says. “You need functionality, but without support the software won’t do you any good.”

The best vendors will educate data entry people and administrative staff from the start. To maximize efficiency, your team will need to learn how to use the software to the fullest. Clay says he looked for a vendor that would train his people up front and take care of problems quickly.

Still, Domos cautions providers to keep expectations realistic when it comes to technical support. “Don’t expect them to be there for you every moment,” Domos says. “Look for a 24-hour turnaround time when it comes to the vendor trouble-shooting your problem.”

Clay says he appreciates what a challenge it is for today’s vendors to keep pace with the changing industry environment. As rules and regulations change, vendors will make changes in your existing software. “Updates come approximately once a month, and very often these are sent to us   online,” Clay says. It is critical to choose a vendor that delivers updates in a timely fashion, explains the new version, and eliminates any bugs in the programming.

Aside from offering training and support, you will want to choose software that is user-friendly and a vendor who can innovate. For example, you may want to start with a basic software system, but make sure the vendor can add features like bar coding and document imaging. The best vendors will work to determine a solid starter package with an eye on ways to enhance productivity in the future.

Software is a big investment, with systems ranging anywhere from $10,000 to $40,000, so take your time choosing. And remember, a bigger price tag does not necessarily mean better results. “There are plenty of reasonably priced software packages out there,” Domos says. “It is not always the most expensive that is best for a business.”

Clay Home Medical met with five vendors who each provided a demo. Still, Domos says that a 1-hour demo may not be enough to base your decision on. Don’t be shy about asking vendors to loan you a demo disc for a given period of time. Many are happy to provide you with a disc for as long as a month. “See if the vendor will let you test out the software at your leisure, so you can really assess how it works for your business,”  Domos says.

In addition, you can get a good feel for the scope of software options at trade shows like Medtrade. Talk with colleagues and find out what works for them, research options at industry associations and state agencies, and don’t be coy about asking for references. Call a handful of the vendor’s existing customers and learn about their satisfaction level with the product and the company.

You might also want to talk with a consultant about software for your business. Consultants have seen it all and may well be able to advise you on a system that meets your particular needs. Finally, make sure you get everything in writing. Once you have decided on a vendor, the product and service expectations should be clear. Your agreement should outline the training hours and trouble-shooting time included in the contract.

Making the Transition
 Clay recommends a slow transition. “For cash flow reasons, my advice is do not discontinue your old software right away,” Clay says. Consider, for example, rental equipment like wheelchairs and hospital beds. If you plan to bill 100% of items, 20% might be new, while 80% of your billing is for rentals from months prior. Clay recommends billing the older orders on your old software system, just in case your new software does not operate effectively at first. “It takes time to learn a new system,” Clay says. “So learn on 20% of your business, not on 100%. This way, you can be assured that the cash flow is there.”

Marianne Matthews is a contributing writer for Dealer/Provider.