HME Business Handbook: Software

How to Automate Key Steps In Your Patient Workflow

Providers must deliver stellar service in the face of reimbursement cuts, which means they must maximize workflow efficiency. How can the industry's software offerings help?

The number of tasks that providers perform in order to ensure good service is voluminous. From working to educate referral partners, to on-boarding new patients, to ensuring smooth claims filing, to delivering and setting up home medical equipment, to coaching and keeping in touch with patients, providers engage in a laundry-list of complex tasks designed to benefit outcomes and maintain patient and referral partner satisfaction.

That good service represents providers’ competitive edge. The more they can do to ensure patients are benefitting from their HME and related products and services, the more that will reinforce their relationships with those patients and their referring healthcare professionals. Moreover, it also enhances the provider’s reputation for good care and expertise.

However, the sad fact of life in the funded-care world is that reimbursement is declining. Even with retail sales and other revenue sources, providers must still provide that sterling service — and that service is expensive. It requires people, assets and processing that take time and cost money. So how do HME provider businesses offer the kind of service that keeps them engaged with patients and referrals, but do so in a highly cost-conscious and competitive environment?

It comes down to automating as much as the patient workflow as possible. Fortunately, the industry’s software companies have been working to help providers do this. Let’s examine how.

START AT ENROLLMENT

Patient workflow automation begins at enrolling the patient. The provider’s software should assist in gathering patients’ basic information, as well as their insurance information, and their referring physicians. The system should be running eligibility, and ensuring that patients have coverage, as well as what that coverage offers in relation to the physician’s prescription.

Fortunately, HME software is benefitting from considerable automation that is happening in other corners of healthcare. Many payers now have portals that let providers login and retrieve patient eligibility data, such as patients’ coverage and deductible information. The method of connectivity and information can vary from payer to payer but the information is there, and software systems can retrieve it, which greatly helps automate this step.

Moreover, HME software should be automating claims documentation to ensure all the necessary information is entered so that a clean claim gets submitted the first time around. Particularly in today’s audit-heavy environment, if there is any incomplete information, then the system needs to hold that order until the information is collected. Here again, the system should be helping to automate documentation requests and follow-ups.

CO-PAY COLLECTION

Another thing the software system should automate is the process for collecting patient co-pays. The billing system should help facilitate and automate the accounts receivable procedures that many HME providers are familiar with in terms of collecting the co-pay. The idea is to make as many of the contacts as automated as possible to diminish the cost of each co-pay.

If the provider is dealing with on-site transactions, this should take place at the provider location. The software should leverage the point of sale system to help the provider collect the patient co-pay.

PROVIDING THE HME

Once a patient’s order has reached the point in the workflow where the HME can actually be provided to the patient, software again can help automate this step and save providers considerable cost. For the HME that must be delivered to patients’ homes, a provider’s delivery operations rank as a major overhead element within many providers’ finances. There are multiple costs associated with a delivery operations: drivers and dispatch staff; the cost of the vehicles and their maintenance; fuel costs; the cost of the inventory stored in the trucks; the additional insurance, registration; and other costs related to owning and operating a vehicle fleet. Providers need to make their deliveries count.

HME software should automate their deliveries. Fortunately, many systems have gone to considerable lengths in this regard. For starters there are route-planning solutions that help optimize each day’s deliveries to that the mileage covered by each driver and truck is maximized.

Moreover, GPS tracking lets providers track their vehicles while they are out in the field. A GPS device is installed in the vehicle, or a GPS-enabled smart phone or similar device is carried with the driver. These units are tracked by a centralized system, and the HME business logs into the system to see their vehicles and track them. The provider can see a variety of information about each vehicle, such as its current and average speed and mileage, to ensure they are on plan and within cost, while still providing solid service levels.

PATIENT COMMUNICATION

From on-boarding, to delivery, to follow-ups, to coaching, to resupply, providers engage in a multitude of dialogs with their clients. However, without software, the main way they perform those communications is via the phone. The phone offers great service, but at a time when providers are seeking every possible efficiency in order to drive cost out of their businesses and reinforce their margins, all that manual patient contact is a primary cost-cutting target.

So again, automation is an attractive option when it comes to overhauling providers’ patient communications.
They already have tools such as interactive voice response, email and online contact to orchestrate the process. Providers can leverage their software to organize their client contact efforts and permanently drive a considerable level of cost out of their business, while perhaps increasing their revenue through co-pays and resupply orders, so the notion of automation seems like a no-brainer.

To that end, providers have started using those tools, but now we are even seeing text messaging come into place. Texting support lets patients interact via quick-and-easy texts in the same way they might interact with their pharmacy about a prescription. And even in the case of manual phone contacts, HME software systems can help organize those contacts to help save time and money.

The bottom line is that HME providers shouldn’t fear automating patient contact and should work to implement it. If anything, it will enhance their service.

POINTS TO REMEMBER:

  • Providers engage in a number of tasks in their patient workflow that are costly, but add to the service levels that they use to differentiate their businesses.
  • With reimbursement declining and the market growing more competitive, providers must automate these processes where possible.
  • Patient workflow automation starts at enrollment. With all the data providers must collect, they need to automate this process. Automation in other parts of healthcare is making this easier.
  • In addition to processing claims, providers need to automate co-pay collection.
  • Other time- and cost-consuming steps in the patient workflow that HME providers should automate include delivery management and patient communications.

LEARN MORE:

Check out our the HME Business Software Solutions Center to learn more about getting the most from your HME billing and management software.

This article originally appeared in the June 2019 issue of HME Business.

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