Managing DME/HME companies requires people to shift from a cost center to a profit center view. In a recently conducted survey, results revealed that 97% of DME companies struggled with asset, productivity, growth, or workforce optimization.

These things are also correlated with revenue cycle function which translates to an average of 15% to 25% operating costs. Companies have begun adapting to revenue cycle issues and they have expanded beyond by focusing on the following issues:

  • 100% accurate inputs at the order-entry stage, yielding clean claim submissions
  • Adhering to medical necessity eligibility criteria at a 100% rate
  • Well-rounded knowledge of payer/product rules for acquiring appropriate documents, as to avoid denial
  • The industry has also used technology and specific processes to tackle these factors. However, the idea of monitoring the variables in order to achieve success is crucial. This involves:
  • Shifting payer and product mix as well as sales effectiveness in order to analyze demographic factors and notice gaps
  • Seeing a large amount of regulatory audits because of increasing scrutiny of appeals and processes that have risen significantly because of claim rejections
  • Product mix changes due to sales strategy shifting and price swings

These factors are significant when it comes to how it affects providers that have small margins, competitive bidding, and payers that are dictating difficult contracts. The result is billing and collections teams across the industry that are responsible for negative results.

How can it be remedied?

  • Data analytics can be accessed and analyzed closely to recognize historical trends.
  • Develop a revenue projection blueprint that can map out inflow to cash yield. The results can be compared to actual performances so companies can see where the follow stops and how to remedy any issues
  • Develop a reliable team that can review processes on a regular basis, identify any opportunities, and design ways to capitalize on the processes in order to bolster the bottom line
  • Developing a feedback process that creates awareness among companies and the issues that they’re facing, getting directly to the origin and roof of the issue
  • Create a forecasting model that takes advantage of predictive analytics and historical data in order to create an alert and accurate tool

What’s the result?

By following through with the above step-by-step process, companies will have a high-functioning forecast model that can help serve as an alert tool, pinpointing probabilities instead of just random targets. This means that leadership teams will have the tools to evaluate cash results quickly and efficiently.