Despite the difficulty of selecting and fine-tuning the right applications, an integrated suite of software applications, whether run in-house or externally by an outsourcer, is essential for every HME.
Research and shopping are the most difficult parts of the software-selection process. It’s tedious because comparing one system with another is rarely straightforward. Vendors configure their software differently, even though they all attempt to automate the same processes. To avoid being overwhelmed by everything on offer, all of it promoted as best-in-class and unrivaled, you need a method. So, here?s some guidance from independent experts on researching your various software options.
Here are the essential questions to ask your vendors. If possible, get them to actually show you how their system works with regard to each feature or functionality you?re interested in.
1. What are the elements of your solution? Every solution will have certain common components, like claims management and inventory tracking. The key here is to look for functionality that tracks with your conception of how your business should run. Maybe you like to set up patient follow-up appointments yourself because it adds a personal touch. So, perhaps you don?t need an automated scheduling system that automatically generates appointment notices.
2. How well are the elements of your solution integrated? This is perhaps the most important criterion. From patient intake to the applications that schedule deliveries and route delivery-trucks, all the applications should effortlessly communicate. Ask to this capability in action, preferably at an existing customer’s location. Make sure you can clearly see how information and work products flow from one application to another.
3. How much flexibility does the solution allow in areas that are especially important to you? For example, perhaps you have a fairly even mix of Medicare and non-Medicare payers. Does the claims-management system allow for statements and claims to be directed to multiple insurance plans? Can you store Medicare and other forms in the system and easily populate them with patient information and, then, either print them or electronically submit them to a payer, patient, or physician.
4.Are the applications user-friendly? Do they invite engagement, or are they off-putting because too cluttered, intimidating, or confusingly organized? Do they seem complex and hard to understand or transparent and intuitive? Will your staff be able to learn them fast? Ideally, applications should combine simplicity and the power to get the work done.
5. Do the applications, particularly those dealing with inventory, accounting and finance, and documentation, satisfy and support CMS? accreditation requirements? Do they have the financial analytical power to support you in preparing Medicare bids?
6. Do the applications support these functionalities: CMN tracking, claims processing, automated claim generation, scheduled billing, on-demand explanation of benefits, rejection/denial management, and secondary-insurance claims?
7. What are the most innovative aspects of the applications? For example, some applications detect errors in claims and orders, making it difficult to submit documents that will be rejected or returned. Others keep track of expiring authorizations, preventing costly billing-cycle disruptions.
8. Take a close look at billing systems. Be sure to clearly understand how good they are at getting bills out quickly and accurately? Do they provide automatic recurring billing?
9. How comprehensively does the solution automate the reimbursement process?
10. Does the solution automatically accommodate Medicare and private-insurance updates?
11. Does the solution’s Inventory system measure up? Inventory components range from mere spreadsheets to integrated barcode technology that provides real-time inventory data, identifies products that have been recalled or superseded, and enables rapid ordering and fulfillment.
12. Do the solution’s reports give you a comprehensive picture of your business rather than discrete reports that make it difficult to turn data into knowledge for decision making?
13. Does the solution provide a comprehensive scheduling function? Some track and remind you of equipment-maintenance schedules, patient follow-ups, and service calls. Do you need this capability?
Taking the time to probe the issues covered by these questions will pay off. The choices you make will have a decisive affect on your business, so it’s crucial to choose well. As industry conditions become more challenging and margins narrow, the competitive edge you can get from powerful, effective IT solutions may make the difference whether you can stay in the game.
