Billing systems growing in sophistication

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Monday, April 29, 2019

For HME providers considering upgrades to their billing systems, it is important to know that today’s automation technology allows for full integration of functions that span the administrative and operations continuum within the company. In essence, a new billing system goes well beyond revenue cycle transaction and into every essential part of the business.

“It’s an exciting time for HME providers as it relates to technology, and there are many integrations that are available,” said Rob Boeye, executive vice president for HME at Lawrenceville, Ga.-based Brightree. “In the current environment, HME providers need to figure out a way to have a competitive advantage—utilizing technology and integrations will assist them in differentiating their companies when it comes to improving operational costs and servicing their referrals and patients.”

Integration of automated functions results in greater efficiency, which Wayne van Halem contends is paramount in an HME business environment where reimbursement is continually shrinking.

“Efficiency is necessary for survival,” said van Halem, president of Atlanta-based The van Halem Group. “Technology is a way to capitalize on efficiency and streamline processes. Billing system integration can also result in automation that reduces the risk of human error. Opportunities to reduce human error result in savings and in limited exposure of risk to a provider’s business.”

Christopher Dobiesz, president of Davison, Mich.-based Universal Software Solutions, calls system integration “the most obvious game changer for a provider’s efficiency metrics.” Not too long ago, users had to do double work in two separate domains, while he says new integrated systems allow employees to be “reallocated to areas of the business where they can have more impact.”

Compared to early editions of billing systems, the breadth and depth of today’s systems allow a 360-degree view of business operations rather than a keyhole view, said Gail Turner, HME software sales consultant at Billings, Mont.-based Computers Unlimited, developer of TIMS Software. Therefore, she said one of the biggest advantages of integrated software is the breakdown of fragmentation within companies that have traditionally used separate system pieces to operate.

“This caused major inefficiencies, such as data duplication or omission, human errors and ultimately the loss of the ability to monitor the timely filing of claims,” Turner said. “Data from the entire revenue cycle is seamlessly updated in real time. An integrated solution shares the same database, working tightly together to reduce errors and downtime so that all information is immediately gathered, stored, and reportable.”

Automation advantage

From the patient-pay billing and collection perspective, automation eliminates the need for the provider to resource and manage multiple vendor processes, said Bruce Gehring, senior vice president of development for Overland Park, Kan.-based Allegiance Group.

“After generating, printing and mailing the statements, any patient collection follow-up activity, such as reminder calls, online payments and collection agency services, are handled in one comprehensive solution that is integrated with medical billing software,” he said. “It helps providers to better prioritize patient pay collection activities for their staff and allows the staff to focus on other tasks critical to the success of the business.”

Boeye added that automation has not only allowed providers to become more efficient, but it also helps them improve compliance in the areas of reimbursement, regulations and audits.

“Providers can utilize document management software that gathers all the pertinent patient information in one place, ensuring that you are filing clean claims and are able to respond to potential audits quickly,” he said. “Additionally, using the right technology partner keeps your system up-to-date on regulatory and reimbursement compliance issues to take that burden off of you. It’s critical that your technology supplier helps you to reduce or eliminate the paperwork that exposes you to audits by automating the intake and claims processes.”

New innovations

In pointing to Application Programming Interface as the wave of the future for the HME industry, Fresno, Calif.-based BFLOW Solutions CEO Ted Jones says providers are starting to demand open enterprise resource planning software “that allows an organization to manage day-to-day business activities, such as accounting, procurement, prescriptions, fulfillment, merchant funding, billing and benefit solutions in one seamless application.”

Innovations within the patient-pay billing and collection realm include more text communications for payment reminders, statement notifications and payment authorizations; more patient-driven services offered online; and improved reporting functionality to provide more flexibility and customization to track specific key performance indicators, Gehring said.

To be sure, “technology is evolving at an extraordinary pace,” Turner said, and as a result, “providers can expect to see continued streamlining of daily processes through mobile application developments—from routing to delivery to patient payments.” Through these mobile apps, she said it is possible to increase the number of deliveries with optimized routes while also reducing fleet and labor costs.

Finally, Kelly Grahovac, senior consultant with The van Halem Group, believes that adoption of e-prescribing is inevitable.

“E-prescribing will be an innovation that will offer providers benefits in the ways of process automation, increased accuracy of information and a timelier referral process,” she said.