Consultant's corner: Roberta Domos takes her own advice

REDMOND, Wash. - There's a good reason why you haven't seen HME consultant Roberta Domos on the speaking circuit in a few years.

“We've been downsizing,” said Domos, owner of Domos HME Consulting Group, which has been in business since 1999. “We've done the same thing HME providers have been doing: We're not bothering with not-profitable businesses anymore. If there's one thing I know how to do, it's take my own consulting advice.”

Over the years, the group's business has shifted from helping entrepreneurs with startups (“I used to have 15 to 20 going at a time; now I have one or two”), to helping providers with the accreditation process (“We did a bang up business with that through 2009”), to helping them with the billing process (“There's not less work to do. There's just as much to do, but the revenue has been cut like crazy”).

Most recently, Domos has focused her consulting work more specifically on helping providers shift billing overseas.

“We long believed that the front-end—insurance verification and documentation—was easy to do overseas,” she said. “Outsourcing the billing and collections piece is more risky, but with such huge cuts in reimbursement, it has to be an option for billing, too. The margins are just too tiny not to consider it.”

 With business slowing down, Domos, 56, has retirement in her sights, but not quite yet.

“You always have to be looking at the next thing and be ready to pivot,” she said. “You have to diversify. You have to outsource. You have to offshore. You always have to be thinking.”

“The providers in this industry have helped a lot of people,” Domos continued. “It's sad it's not respected more than it is. There are providers out there with hearts of gold. They're really good people.”