Subscribe to Smart Talk

Smart Talk

Contracting: Beware these contract pitfalls

Q. What are some red flags in payer contracts?
 - 
10/21/2016

A. In addition to contracted rates, there are key items often found in payer contracts that can significantly affect and often reduce reimbursements. Here are a few to look for:

Merchandising: Watch the signs

Q. Is department signage important?
 - 
10/21/2016

A. Department signage is ubiquitous in retail. Imagine walking into a Home Depot without signage directing you to a department. For most retail HME stores, however, I think it’s unnecessary.

Mergers & Acquisitions: Assess risk and value

Q. What can I do to increase the value of my DME company?
 - 
10/21/2016

A. Here’s a step-by-step approach to protect your investment:

Understand how valuation works 

ALJ Appeals: Increase your success rate

Q. What can suppliers do to increase their chances of success during the Medicare appeals process?
 - 
10/21/2016

A.

Contracting: Offer best value proposition

Q. How can I get contracted into closed and narrow networks?
 - 
09/29/2016

A. It is often challenging for HME companies to get contracted with payers. Payers often close their networks to new provider applications once they reach a certain number of HME companies. 

Merchandising: Make your store POP

Q. Some of my vendors want to send me point-of-purchase materials for my store. How do I decide which ones would be most effective?
 - 
09/29/2016

A. If your vendors want to send you POP materials, be happy. Only a handful of HME vendors understand retail and the need to help you be “retail friendly.”

Mergers & Acquisitions: PE groups seek strong managment

Q. If the DME market is in such rough shape, why is there so much private equity group (PEG) activity?
 - 
09/29/2016

A. There are several factors contributing to strong PEG interest. First, DME entrepreneurs are finding new ways to operate profitably. Second, there have been numerous “roll ups” of smaller DMEs within geographic areas.

ALJ Appeals: Pay attention to details

Q. What are some best tips for defending claims—from ADR letters to ALJ appeals?
 - 
09/29/2016

A. A home medical equipment supplier can protect its profit margins from recoupment by establishing a compliance culture that collects adequate documentation and submits proper billing claims, but it is equally important for a supplier’s bottom line to defend and appeal erroneous Medicare recoupments.

Human Resources: Make positive first impression

Q. Should you have a formal onboarding process for new hires?
 - 
08/22/2016

A. An effective onboarding program takes work and planning to ensure new team members can hit the ground running and feel welcomed from day one.

Overpayments: Create culture of compliance

Q. What is the best remedy for overpayment problems?
 - 
08/22/2016

A. In previous columns, I discussed how the 60-day overpayment rule presents a myriad of problems and questions that are sometimes difficult for an HME supplier to identify and address.

Pages