Market for back-office services growing

Automation technology has made great strides within the HME industry, organizing and streamlining operational office functions that go beyond billing. That progress has changed the dynamic of a provider’s financial processes and business workflow. 

“Basically, there are many areas in the HME provider’s business, including revenue cycle management, where advanced technology and automation – including artificial intelligence – can be used to improve process throughput, reduce errors, and free up people to focus on high-value work and exceptions,” said Joey Graham, chief revenue officer for Charlotte, N.C.-based Prochant. “Systems of the future must include significant, intelligent automation, as well as the ability for patients to self-service via online patient portal and mobile applications.” 

Outside help 

While automating internally has continued to advance and establish itself within HME companies, outsourcing has also gained traction in recent years, Graham said. There are multiple factors driving them to outsource front- and back-office functions now more than ever, he said.  

“First, staffing – everyone is struggling with finding, hiring, training and retaining staff members,” he said. “On top of that, U.S. labor rates are at an all-time high and going up.” 

To be sure, “outsourcing is not new to the industry – it has been common practice to outsource the complexities of billing and collections for a long time,” said Steve Cela, founder and president of Houston-based Strategic Office Support. “Today, providers are looking for cost effective alternatives to in-house work. The sheer cost savings coupled with the staffing shortage we have been experiencing over the last three years provides a compelling reason to implement an outsourcing strategy.” 

‘Insourcing, not outsourcing’ 

But at its core, Minden, Nev.-based Tactical Back Office positions itself as a staffing agency, not a billing company, says founder Todd Usher, because it tackles intake, customer service, resupply and other operational functions. 

“We provide full-time employees as long as they are needed,” said Usher, whose firm specializes in providing staff from the Philippines. “We are insourcing personnel for a permanent relationship between the back office and the provider. Outsourcing suggests a constant revolving door. We provide continuity for the business.” 

Because staff turnover is a chronic industry problem, Tactical Back Office focuses on cultivating personnel who don’t leave, Usher said. 

“It’s the 11 herbs and spices of what we do,” he said. 

IT & AI adoption 

Information technology is at the heart of business automation and, while the HME industry was originally slow to accept and adopt it, attitudes have changed, Cela said. 

“The HME industry is extremely receptive to information technology,” he said. “HME companies have been keenly aware of the advantages IT affords them in their operations. From streamlining administrative tasks to monitoring patient outcomes in real-time. IT allows HME companies to improve patient outcomes, reducing costs and increasing operational efficiency.”  

Cela adds that artificial intelligence (AI) is the new frontier for the platform that will manage complicated tasks and checks and balances required daily in the HME industry.  

“Soon AI will help further streamline operations, identify key trends in profitability, denial management and data acquisition,” he said. “Imagine a system that is constantly checking for denial trends, claim rejections, erroneous write offs, even successful appeals for various denial codes that it reapplies."