Start your year off right with some advice from the back-office HME and DME experts at Prochant. Speaking with VP of DME Services Melissa Wagner on The Modern Healthcare Back Office podcast, Melissa and our co-hosts dived into six resolutions for providers to work on this new year.
#1 Deductible Season Strategy
As we come up on deductible season, cash flow will be at the forefront of our minds. Providers may be asking themselves, “Do I bill it and then take the risk of having the deductible hit? Do I delay my revenue and hope that when I make the decision to finally release my claims, my patients’ deductibles have been satisfied?”
In November 2023, plan to develop a thoughtful strategy to manage your deductible process. As the provider, have you done some thorough analysis around how many of your patients might have secondary insurance? Can you minimize some of your cash flow delay? Are you using your tools in your system to tell you where patients might land in terms of their deductible? Decide what your risk-reward approach is before the third week of December, and you will be in a better position than last year.
#2 Employee Engagement
Get your employees involved in the processes surrounding billing. Make sure they’re engaged, trained, and aware of the process issues and solutions. This will help them grow and understand the impact everything can have on the business.
Times are changing, as is technology. The software system that helped you last year might not be what’s best for your business this year or next. Help your employees also be prepared to handle things a different way in the future. Invest in your team’s soft skills development to make communication easier when new software or processes start being implemented. It will save you time and prevent errors.
In today’s environment, the healthcare industry is hypersensitive to retention. Make sure your employees feel acknowledged and comfortable on your team.
#3 Payer Engagement
Focus resource time, energy, and effort on having a thoughtful payer management strategy. Have a solid relationship with a payer, so when challenging situations arise, you don’t get ignored by a payer and issues can be resolved faster. If policy changes slip through the cracks, having some credibility with a payer may also make it easier for them to offer you some slack.
#4 Audit Your System
Take a thoughtful approach to managing your system. When it comes to receiving a series of denials, for instance, make sure your team has an approach that allows them to step back and learn what and how it happened. See what trends you can identify and take preventative measures. A good place to start? Check whether your billing system has any helpful tools inside or not that are enabled or configured. Work on preventing denials this way.
Another important measure is to conduct an audit on your system at least twice a year. Go down each menu option in your billing system and decide “Are we using this option? Yes or no?” Don’t underutilize the system you have.
#5 Policy Change Awareness
On top of auditing your billing system, have a preventative approach to policy changes. In the HME industry, change is the one thing that is constant. For example, when Medicare publishes policy changes for the new year, always assign at least one person to have policy or regulatory changes on their radar. Don’t let changes go unnoticed.
#6 Have Fun
Going through your system and uncovering opportunities can be considered fun if you go into it with the right mindset. A “fun project” might mean a new challenge, but if you take everyone’s feedback and keep the return on investment in mind, these tasks can and should be fun!
Have questions on this HME/DME back-office advice? Email Prochant’s VP of DME Services Melissa Wagner at melissaw@prochant.com or Senior Consultant Rachel Schools at rachels@prochant.com, or get in touch with us here.
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Prochant has a proven track record of helping HME and pharmacy providers meet their financial goals. Our scalable solutions, years of experience, and advanced technology provide best-in-class results to the healthcare community. Headquartered in Charlotte, North Carolina, our client base includes national pharmacy and HME providers and health systems.