2015 HME Handbook

How to Use Software to Fine-tune Combined Pharmacy and HME Operations

Running a joint pharmacy/HME provider business that involves a certain level of complexity. Fortunately, software can help.

Software

As most people in the industry know, pharmacies and HME providers are not necessarily mutually exclusive business models. Many providers in the DME industry are also pharmacies, and likely started out as pharmacies that, over the years, started adding various DME items.

But running a pharmacy that also offers medical equipment incorporates a certain level of complexity that might not be apparent at first glance. The business not only must have comply the voluminous requirements of providing prescription medicine to its clients, but it must have inventory, product knowledge, certification, accreditation and likely a competitive bidding contract (at least for wide swatch of the nation). Plus, pharmacies do a considerable volume of retail business, which means it must maintain a back-office infrastructure and up-front point of sales system that supports speedy and accurate cash sales. Without a doubt, combined pharmacy/DMEs are trying to cover several very complex worlds.

Fortunately, software can help. There are certain software offerings in the industry that offer features that support pharmacy/DME businesses, and some are specifically designed with those providers in mind. Let’s take a look at some of the ways these sorts of systems should help pharmacy/DMEs improve their operations and fine tune their performance.

Integrated Patient Records, Claims Processing

For a stand-alone pharmacy with no DME operation, or a HME provider with no pharmacy, there is a more “straightforward” approach to software, but for joint pharmacy-DMEs, the complexity increases. Reason being is that patient records must reflect all of their activity in terms of prescription drugs and equipment received from the provider so that when staff are looking at a patient’s record they have a complete view of his or her “health history” with the business. Likewise, the system needs to be able process claims of all types. If a patient comes in to fill a prescription for some medicine and orders a piece of DME, the provider must feel confident that the software system billed for it all.

Solid Documentation

Audits are a reality that HME providers know all too well, and they are becoming a key concern for pharmacies, too. In fact, pharmacy/DMEs are feeling the pinch when it comes to audits on patient claims for DME. Typically, the issue is missing documentation. A pharmacy/DME must ensure that the software it uses will coordinate with referral partners to collect all the necessary documentation before it moves a claim forward.

The Point of Sales System

A key element in a combined pharmacy/DME system is the point of sales (POS) system. The cash register is where many of a pharmacy/DME’s customers will interact with the business, so providers must ensure their transactions are as fast and efficient as any typical retail businesses, because that will be the customer expectation. That means the point of sale system needs to include all the key items that will make it function quickly and seamlessly. It should incorporate a computer hooked up to a cash drawer, along with a barcode reader and credit card reader. Also, in some parts of the country, the system must also include a display pole that shows the patient individual and total charges for the transaction as they are rung up.

The goal is to ensure that the point of sales system offers as smooth as possible implementation path for the provider. Bearing that in mind, seek software offerings that either support specific point of sales systems or that offers a point of sale systems that is integrated with the software systems. If the software vendor doesn’t offer one, you’ll want to review which self-contained point of sale systems from name brand third-party vendors the software supports, the features they offer, and what will be involved in terms of integrating those systems.

Two Key Capabilities

Because pharmacy/DME businesses are so retail-focal, there are two key features that must be supported: credit/debit card process and barcoding. The POS system and software should include a card swiper and PIN pad and should support credit and debit card processing capability. The point of sales system must process credit card transactions as quickly as would any other retail business. Look for systems that offer credit card processing software integrated so that you don’t have to pay a rental fee on a credit card terminal. Moreover, an integrated system will update all patient records with retail transactions.

Similarly, bar coding is essential. Pharmacy customers will expect fast, efficient transactions. To that end, barcoding is a critical point of sale element because it reduces the number of steps and automates as much of the retail transaction as possible. A good point of sale system should be able to scan the barcode on a product and immediately capture the product number, serial number and automatically bring up the pricing. But in addition to that, the transaction should be tied together with other back-office processes, such as deducting the product from inventory and entering the product into the customer’s patient file when the transaction is complete. If those steps had to be undertaken manually during a retail transaction, the customer probably would have abandoned that transaction.

Co-Pay Collection

One thing the joint pharmacy/DME system should support is the ability for the provider to collect patient co-pays on the spot. Given that the pharmacy is essentially a retail business, the software should leverage the point of sale system to help the provider collect the patient co-pay. And if that co-pay isn’t collected then, the billing system can carry out the accounts receivable procedures that many HME providers are familiar with in terms of collecting the co-pay.

Points to Take Away:

  • Pharmacies and HME providers both run very complex business, so joint pharmacy/DME businesses require software that can give them a smooth workflow that addresses the challenges of both.
  • The system should integrate patient records and claims processing for all patients, as well as ensure that all claims — pharmacy and DME — are properly documented.
  • Because pharmacies are retail-heavy businesses, having point of sales systems that provide fast transactions while also offering back office integration are critical.

Learn More:

This article originally appeared in the June 2015 issue of HME Business.

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