Inadequate Staffing

One of the most obvious effects of overly lengthy processes is inadequate staffing. If an employee’s time is being stretched thin because they have to complete too many tasks at once, then they won’t be able to do their job as effectively as they could if they had enough staffing. If a single employee is responsible for cleaning the entire hospital, stocking the supply closets, and updating the inventory management system, they’ll inevitably fall behind on one of those tasks. At best, patients will notice a slight decrease in the cleanliness of their hospital rooms. At worst, they’ll be at risk for contracting an infection because the staff member didn’t have time to properly sanitize their rooms. If an employee whose job is to update the inventory management system also has to complete patient billing, then a patient’s paperwork might not be processed accurately. The same goes for medical records. If a single employee is responsible for inputting every detail from each patient’s chart, there’s a chance that tiny but vital details will be missed.

Duplicate Responsibilities

Yet another negative effect of lengthy processes is that they often result in redundant responsibilities. For example, if one department is responsible for scheduling patient appointments and another department is responsible for updating the online calendar, there’s a chance that both departments will input the same information. This can happen when multiple departments have overlapping responsibilities. For example, a department responsible for scheduling doctor appointments also schedules patient appointments, and a department responsible for updating the online calendar also maintains the departmental calendar. In these situations, it’s important to note the differences between the two types of calendars. A calendar used for scheduling appointments is often used for internal purposes only. On the other hand, a calendar used to update patient appointments is often used for external purposes, such as posting the appointments online for patients to view

Manual Tasks That Are Time-Consuming and Tedious

Depending on the type of industry a person works in, completing manual tasks might be a regular occurrence. However, many healthcare employees find themselves trapped in a never-ending cycle of manually entering data, reviewing charts, and more. Manual tasks that are time-consuming and tedious include manually entering data into several different systems, manually reviewing patient charts, manually taking inventory of supplies, and manually logging time. Manual data entry is often necessary when the process that feeds data into a system doesn’t work correctly. For example, an inventory management system might not recognize when a box of gauze is used up, so an employee must manually enter the information. When manually reviewing patient charts, an employee must read through each chart and manually record information. For example, they’ll need to check each chart and manually record the patient’s ID number, allergies, and any other pertinent information. When manually taking inventory of supplies, an employee must manually count each item in the supply closet. This includes manually counting each box, bag, and jar of each type of supply. When logging time manually, an employee must record how much time they spend on each task in the day. This is often done on paper, but some companies have moved to electronic logging systems (ELPs) to make the process easier.

Loss of Patient Data Accuracy

Accuracy is crucial when it comes to healthcare data. But, when a single employee has to manually enter information into several systems, there’s a higher chance of inaccuracies creeping in. This is especially true when that employee is responsible for entering information quickly and accurately. For example, an employee may incorrectly record a patient’s name, birth date, allergies, and other information when manually inputting data. This can happen when they’re rushing to enter data and don’t take the time to double-check each entry. When it comes to an employee manually entering data into several different systems, there’s a higher chance for inaccuracies. For example, the employee may incorrectly record a patient’s allergy information in one system, but correctly record it in another system. This data discrepancy can lead to the wrong type of treatment being administered during an emergency.

Waste From Discrepancies in Data

Healthcare providers often use data as a benchmark for patient care. For example, if one hospital’s patient-to-nurse ratio is 6:1, and another hospital’s patient-to-nurse ratio is 9:1, they’ll use that data to determine which is the better hospital. Unfortunately, when hospitals are using data that isn’t accurate, they’re just wasting time and money. For example, if two departments are inputting the same information into different systems, there’s a chance that the information will be inaccurate. When two departments are inputting the same information into different systems, there’s a chance that the information will be inaccurate. But, if two departments are inputting different information into the same system, there’s a chance that the data will be inaccurate. For example, if one department is responsible for manually entering data about a patient’s allergies and the other department is responsible for manually entering data about a patient’s allergies, there’s a chance that one department will incorrectly record the information and that the other department will correctly record it.

Constant Change is the Only Constant

A final negative effect of lengthy processes is that they often lead to constant change. This is especially true when an organization is adding new technology or switching up procedures. When an organization is undergoing constant change, it can be difficult for employees to keep up. For example, an organization might decide to implement an electronic medical record (EMR). Unfortunately, an employee may be uncomfortable using the new system or they may take longer to become familiar with it than the organization would like. This can lead to growing frustration on both sides. Additionally, an organization may decide to use a new software system for scheduling appointments. Unfortunately, an employee may be more comfortable with the old system. This can result in employees taking longer to manually input appointments and feeling less efficient than they did with the old system.

Conclusion

The healthcare industry is filled with lengthy processes that can negatively affect employees if they aren’t streamlined. It’s important for healthcare providers to work with their employees to improve processes and help employees become more efficient so they can spend less time on manual tasks and more time providing the best care possible.

Let’s Talk Results

Your practice’s revenue cycle management is the process of collecting, tracking, and reporting on your payments from patients and payers. If you’re not collecting 100 percent of your revenue, it’s not only costing you money—it’s also hurting your reputation with patients who may decide to go elsewhere when they have a choice. Even worse, failing to collect all of the money due to your practice can result in penalties and potential legal action if one of your patients ends up having trouble paying for something.

Many practices make the mistake of assuming that if they collect patient-pay and insurance payments prior to a procedure, they will have no remaining receivables. But a successful practice must look at the following three key factors to implementing a successful revenue cycle management process:

To manage the revenue cycle more effectively, there are three key factors to keep in mind:

• Revenue management
• Eliminating A/R
• A/R management

Revenue Management

Revenue management is the process of managing the amount of money that a business receives from customers. it’s important that you know how a practice’s revenue management works and how it affects the patient’s access to care.

Eliminating A/R

A/R management is an important aspect of your practice that helps you collect your accounts receivable. Effective A/R management can significantly improve the cash flow in your practice.

While many practices focus their time and effort on bringing in new referrals, it is equally important to spend some time managing the accounts receivable process so that all of your hard work will be rewarded.

A/R management

A/R management is an important part of running a practice. If you are not collecting your revenue, then you will have problems paying your bills. The first thing that you need to do is understand why the A/R is not being collected. It could be because of any number of reasons such as:

• The patient does not have the money to pay
• Your invoices sent out are too complicated or confusing
• You haven’t been sending out reminders when they were due.

To address these problems and get those claims paid, there are some steps that you can take:

1.  Keep track of all unpaid claims so that they don’t get lost among other papers in your office – this will help prevent late payments from happening again. 

2. Be sure that anyone working on billing understands how important it is for them to send out claims about upcoming deadlines for payment before time runs out for collection purposes; otherwise, there won’t be anything left in their accounts at all! Remember also never let any items go past 180 days without sending out reminders–this usually results in more debt collectors coming after us later down the road which costs more money than simply doing things correctly upfront.”

The best way to ensure you are collecting every cent of your revenue is by using an efficient and effective revenue cycle management solution.

When it comes to revenue cycle management, there’s no such thing as “good enough.” The best way to ensure you are collecting every cent of your revenue is by using an efficient and effective revenue cycle management solution.

A good quality revenue cycle management system will help you:

• Automate processes in order to house more patients and increase revenues
• Reduce expenses and increase patient satisfaction through better communications between the front desk, doctor offices, and back office staff
• Improve productivity by streamlining workflows across multiple locations

Conclusion

The key to successful revenue cycle management is understanding the three factors of revenue management, eliminating accounts receivable, and A/R management. These are all critical processes that must be in place in order for any practice or business to maximize the potential of its collections and stay profitable.

When you are shopping for coverage, you might be wondering why some plans cover benefits from network providers but not out-of-network providers. While the two types of providers aren’t exactly similar, there are significant overlaps between them. An out-of-network provider is a doctor or other healthcare professional who services patients that your plan does not have in their network. A network provider is any doctor or other healthcare professional who services patients that your plan does have in its network. In order of frequency, the major differences between an in-network provider and an out-of-network provider include the following:

What Is an In-Network Provider?

An in-network provider is a doctor, hospital, or another healthcare professional who primarily services people enrolled in your plan. If you need treatment from someone outside your plan’s in-network network, you may be out of luck. You’re not necessarily covered if you choose to see an out-of-network provider. You may, for example, be charged higher fees. But that’s often up to your insurance company.

What Is an Out-of-Network Provider?

An out-of-network provider is a doctor or other healthcare professional who primarily services people not enrolled in your plan. You may have the option to see this provider, but you may have to pay higher out-of-network rates or be charged higher co-pays or other charges. You may have the option to see this provider, but it may take longer to get an appointment. You may have the option to see this provider, but there’s a chance you won’t be able to get the treatment you need.

Why Are Some Plans Covering Network Providers, But Not Out-of-Network Providers?

Some plans cover benefits from network providers but not out-of-network providers. In some cases, this may be because your plan’s network just happens to include a lot of in-network providers. In other cases, the plans may cover only a small number of providers. Most plans, for example, only cover hospitals and/or doctors within their network. Some plans may cover fewer providers, including a smaller network of specialists.

Which Network And Out-Of-Network Providers Do Your Plans Cover?

Each plan is different. Your best bet is to do a little digging on your own to find out which network and out-of-network providers your plan covers.

How To Find Network And Out-Of-Network Coverage For Your Healthcare Needs

If you need help finding which network and out-of-network providers are covered by your plan, ask your insurance provider’s representative. (This information should be available to you in your Insurance provided ID card) You may also be able to find out your plan’s network and out-of-network coverage through your state’s insurance department website.

Bottom Line – Be Careful When You’re Choosing Coverage

If you don’t understand your plan’s coverage and how it compares to other plans, you could wind up paying more. Make sure you’re clear on your plan’s network and out-of-network benefits.

To Explore Additional Data On Insurance benefits and coverage click here.

With WWS your facility will be able to:

Keep patients in a compliant and billable status.

Keeping patients in a compliant and billable status is important for all healthcare providers, but it’s especially so for those who rely on payors to pay their claims. If you’re not following your payor requirements, you risk losing money on every claim that goes unpaid. These costs can quickly add up and cause serious financial strain on your practice or health system.

By using the right tools, you can keep your patients in a compliant and billable status by:

• Keeping up with insurance company requirements for renewal & expired Prior Authorization.

WWS’s unique approach to managing Prior Authorization is beneficial to DME providers. With WWS, you can save time by not uploading the same documents over and over again, and you can avoid redundant administrative work by using our secure electronic transfer of documents. giving you the ability and time to focus on patient care or other important tasks.

• Increased workload for administrative staff
• Reduced ability to attract and retain business opportunities 
• Reductions in reimbursement from government and private payers

• WWS saves you time by not having you upload the same documents over and over again. We gather all of your documentation in one place, so it’s ready when your payor requests it. This means less work for you!
• Serve ensures that you get paid for the services you provide by working with many different payers and helping them understand how much they should be paying for your services or products in order to create accurate claims, which leads to quicker payment cycles—meaning more money in the bank!

Conclusion

We think the best part of the WWS approach is that it saves you time and effort with its automatic uploads and real-time updates. It’s a simple, elegant solution for a problem that many healthcare providers don’t even know they have. We believe that when it comes to revenue cycle management, this kind of innovation can make all the difference—not just in your bottom line, but also in your ability to provide quality care to patients who need it most. If you want more information about how WWS can help you increase your collections while reducing administrative costs, we encourage you to reach out today.

It is important for you to take charge of getting your DME.  You know best what you need and it is your responsibility to make sure you get equipment that will work for you. This process can go more smoothly if you attend to the details

1. Who can get DME?
2. What are the steps in getting DME paid for?
3. What are the most common reasons for denial of payment?

What is Durable Medical Equipment?

According to the Centers for Medicare and Medicaid Services, is a health care device that helps a person with a mobility limitation to conduct activities in their home and community.  This includes such items as wheelchairs, walkers, oxygen tanks, communication devices and hospital beds. The Centers for Medicare and Medicaid Services defines durable medical equipment  as any equipment that:

1. Can withstand repeated use
2. Is not useful to a person who does not have an illness or injury
3. Is appropriate for use in the patient’s home

It’s strange how they think we are all sick and stuck at home, and that getting around is a medical issue!

What Are Some Examples of DME?

 DME is considered to include:           

• Equipment that can help you to get around more easily such as canes, crutches, walkers, wheelchairs or scooters.
• Equipment that you may need to care for yourself at home such as hospital beds, raised toilet seats, oxygen tanks, or machines that make breathing easier.
• Equipment that can help you to hear or see better like hearing aids or magnifiers.

DME does NOT include:

• Equipment that is considered “items of personal convenience” or reusable items, such as rubber gloves, catheter tubing, or irrigation kits.
• Equipment that is not considered to be for “medical use,” such as grab bars, lifts or shower chairs.
• Equipment used exclusively outside of the home is often labeled recreational or “used to pursue leisure interests” and may not be covered as DME.

So getting around is a medical issue, but taking a shower is not?? Who writes these regulations?

Who can get DME?

People who are admitted to hospitals and skilled nursing facilities for surgeries, illnesses or injuries will get the equipment they need before being discharged.  In these situations, the equipment that people receive depends on why they were in the hospital. For example, if you go to a hospital for a hip replacement, the hospital will probably send you home with a walker and a raised toilet seat.

The process for getting DME without being in the hospital is different. You can pay for any piece of durable medical equipment yourself. However, because it can be expensive, people usually use their health insurance to pay for DME. Insurance carriers have different guidelines for what equipment they will pay for.  For example:

Medicare pays for DME when you:

1. have Medicare part B;
2. have a doctor prescribe a covered item of DME; and
3. need the device in order to function in your home.

How Do You Get The DME You Need?

Once you have decide that DME is the right choice for you, there are several steps involved in getting it.  If you are able to pay for the equipment yourself, you can go to any DME vendor in your area that has the equipment you would like and you can purchase it.  Depending on whether it’s in stock and available, you may be able to pick up the DME immediately or usually within several weeks. Follow these steps to get your DME.

What is a DME vendor?

A DME vendor is a company that specializes in DME.  DME vendors have staff who are experts in equipment. Some are physical therapists (PT), occupational therapists (OT) and Certified rehabilitation technology suppliers. The vendors work with the companies that make the equipment as well as your insurance carrier.        

How do you find a DME vendor?

Your health insurance carrier may allow you to choose your own DME vendor. However, your insurance company may have a recommended DME vendor, and they may only pay for equipment you get through this vendor. Many times the DME vendor who has the contract for your insurance may not be the best qualified to handle your needs. Ask your insurance carrier what you may do if you are not satisfied with their vendor. You are the consumer!

If you have a choice of vendor:

1. Your doctor can recommend a DME vendor.
2. Ask your friends if they can recommend a DME vendor in your area.
3. Telephone your local drug store, pharmacy or medical supply company and ask if they know of DME vendors in your area.

Who Follows Up On Your Order?

You do. To make sure everything has been filed and the process is going smoothly, you should follow up with your DME vendor. Remember, they handle hundreds of requests so you also will want to follow up with Medicare, Medicaid or your private insurance company directly to check on the status of your claim.

You should keep a copy of every form filed with your request and get any claim numbers and all contact information. Make sure your doctor knows also how long the process is taking and what is happening so that he/she will be able to assist you in following up when necessary.

Conclusion: 

Getting the right gear for your unique needs can be a challenging and time consuming process.  Using the information provided here and attending to the details can help make the process go a little more smoothly and reduce the chance of having your request denied.  It is important that you take charge of getting your DME. It is your responsibility to make sure you get the right gear.

If you need any help in contacting DME Vendors Contact us. Our team will guide and support you with selecting of right DME suppliers for your Medical issues.