10 Microsoft Predictions for 2010

Technology developed by leading hardware and software companies is pushed out to the end users through what is known as “the channel”.  Channel vendors (Value added Resellers and Value added Distributors) are critical to a product reaching critical mass.  As end users, we think we always want to be using the best technology available.  That’s not always so.  What we really want are solutions that will meet our business needs, be easily understood by our staff as it makes them more productive, won’t “break the bank” and most importantly, solutions that are going to keep up and be here tomorrow.

I started working with computers back when they were in special temperature controlled rooms with raised floors and a hard drive was larger than an industrial washing machine.  Inside the “machine room” was a special office for our IBM CE (Certified Engineer).  Although “third-party vendors” could demonstrate superior technology, the old adage that “nobody ever got fired for buying IBM” kept the CE comfortable in his little office. 

When I owned a home infusion software company and would try to get our team to think like a “big company” I would tell them, “If it is good enough for Microsoft, it’s good enough for us”.  It’s not that I thought everything Microsoft did was superior (in fact it is often inferior).  Rather, I knew that Microsoft was going to be around and there is a lot our little company could learn from them.  They were a company we could use as a cornerstone to ours. 

The 2010 prediction season is upon us as people reflect on the year gone by and do their best to predict what will be important for the year ahead.  From a technology perspective, a good place to listen and learn from are the technology channel vendors.  A recent slide show on a site for technology channel vendors gives their Top 10 Microsoft Predictions for 2010.  I’d recommend this as a quick read to stir your thoughts on your 2010 technology plan.  You’ll see some things familiar and probably read about some products that are new to you.  I make a practice of reading predictions from as many sources as I can at the end of the year and then take some time to develop our technology plan for 2010.  At Rock-Pond we believe that we are at one of those exciting times where significant technologies are maturing and the next few years are going to be very exciting.  This is not always the case, but it is as 2009 comes to a close. 

A/R Adjustments – made EASY

It’s bad enough that you have to adjust off accounts receivable. This is money that you have booked as revenue and counted on receiving. In most home infusion companies the adjustment process is a manual process of filling out an adjustment request form, getting it approved by a manager, re-looking up the invoice and applying this adjustment. The end result is a lot of errors, overstated A/R, wasted time by collectors calling on invoices that should have been adjusted, etc.

Rock-Pond Solutions worked with one of our customers to create a report that streamlined the process whereby the collector or cash posting clerk would make the adjustment according to predefined procedures. The manager runs the Detailed Adjustments with Invoice Status report each day to review the adjustments from the prior day and either approve or reverse them with notes in the system to the collector. The results included time savings, improved accuracy, elimination of paper, improvement of audit trails in the system and a much better understanding of why A/R was being adjusted in the first place so it could be prevented. If you are using the CPR+ software and are not using this report – call us right now and we’ll show you what it looks like with YOUR DATA.  If you are using HomecareNET or Ascend, call us and we’ll write this report for your software.  No matter what you are using, you need this adjustment report and it doesn’t come with your software.

Rock-Pond Connect Released!

After 9 years in business, Rock-Pond Solutions has released its first internally developed application.  And we are giving it away for FREE to all of our customers.  Rock-Pond Connect is a server based application that allows us to automatically transfer files to our customers as soon as they are available.Customers install and schedule the application to update based on a desired schedule and they never have to worry about having out of date report templates or other important files they need from Rock-Pond Solutions.

In addition to the obvious time saving advantages this provides to our customers today, Rock-Pond Connect establishes some important infrastructure for some exciting products to be released by Rock-Pond in 2010.

Extending the Value of your Home Infusion DATA

Regardless of what home infusion software you are using, your staff spends countless hours entering data into the system and often comes up blank when looking for information they need to get their job done.  The more data you enter and the more feature rich your software becomes, the more potential there is to exploit the data to get critical information to meet your business goals.  That’s where Rock-Pond Solutions can help.  We will extend the value of the your systems and give you the information you need from the data you’ve got.

Although we’d like to take the credit, the truth is that everything we have produced started with a request from someone working in a home infusion company who had an obstacle or an opportunity.  Welcome to Rock-Pond.com.  Here you’ll find an overview of who we are and what we do as well as regular posts about the things we are doing and problems we are solving.  If you use one of the top  3 home infusion software products (CPR+, Ascend or HomecareNET), the quickest and best way to get to know us is to let us show you some of the reports we’ve developed for other home infusion providers.  We’ll set up our viewer on your system in 15 minutes and show them to you with your data.  We’re looking forward to your call.

Tanguay to Speak at NHIA 2010

Rock-Pond’s president, Pete Tanguay, will present “Understanding and Reducing the Costs of Billing and Getting Paid” on April 13 at the 2010 NHIA Annual Conference in Dallas, TX. Originally Pete was asked by the NHIA educational committee on cost effective use of technology in a home infusion department.  He pointed out that technology is only as good as the problem it solves and understanding and reducing reimbursement costs is very high on the priority list of home infusion providers.

The preliminary course outline is as follows:  “The reimbursement process begins with a patient referral and ends with payment for services, or at least this is the plan. There are specific costs associated with this process and additional costs incurred when you don’t do each area well. This program will present a comprehensive reimbursement model along with specific metrics and recommendations to follow in order to minimize the cost and time it takes to get paid for services. It will emphasize the advantage of using technology to measure and streamline your reimbursement process.The reimbursement process begins with a patient referral and ends with payment for services, or at least this is the plan. There are specific costs associated with this process and additional costs incurred when you don’t do each area well. This program will present a comprehensive reimbursement model along with specific metrics and recommendations to follow in order to minimize the cost and time it takes to get paid for services. It will emphasize the advantage of using technology to measure and streamline your reimbursement process.”

Rock-Pond Solutions will also be exhibiting at the conference.

Managing Billers and Collectors

One of the features of the CPR+ system is you can assign a default biller and collector to each insurance company.  The flexibility allows you to override this at the patient, delivery ticket and invoice level.  This can be a very powerful feature if you need to override the collector responsible for a specific patient or invoice.  However, if you are not careful, you can end up with an unmanageable mess if your biller / collector assignments don’t easily fit into the CPR+ rules, you have significant turnover in your reimbursement department or your payer mix requires that you adjust collectors for workload balancing.

Rock-Pond recognizes this and provides powerful reports you can use to manage collectors based on the default insurance collector or the collector currently assigned to the invoice.  In addition, audit reports are available to alert you when the default collector is not the same as the collector assigned to the invoice.  This is critical because you have to manually reassign the collector when you transfer the balance to another payer or to the patient if the collectore who will rework the remainging balance is different than the one for the payer the invoice was transferred from.

Bottom line, in order to effectively use the biller and collector fields in CPR+, you’ll likely need some additional reporting to manage your data quality based on your current collector assignments and you may need additional reporting to produce reports for your collection manager and collector to effectively do their job.  If you have cases where you have payers that are divided based on the first letter of the last name of the patient, you’ll need some custom reporting unless you are going to have a process to manually assign these at intake.

If there is one thing an infusion company must do it is manage their A/R and determine how to get the most productivity out of the billing and collection staff.  It’s not always easy, but the effort is worth it.

CPR+ gets a LIFE

Each year CPR+ delivers one major upgrade that is announced and demonstrated at their Fall user conference.  2009 is no exception and this year the buzz is that CPR+ is releasing LIFE (Line Item Financials).  Simply put, this breaks out each invoice into multiple claims.  Gone is the limitation that you can only have money due from one payer at a time.  If you want to collect a co-pay up front from the patient prior to billing the insurance company, with LIFE you can do this without putting the money in unapplied cash.  There are many other reasons that this is a very good and needed upgrade.

However, it will not come without some serious consequences.  Consider this:

1. Line item financials will require a data conversion from your current data formats to the new data formats and there is no turning back.
2. The process changes required in your business are so significant that customers who wish to “get a LIFE” are required to go through training.
3. The 3 tables in the database that hold all of the invoice data will be expanded to 9 tables.  All custom reports you have written against these three tables will have to be reviewed, rewritten and retested as part of the implementation process.
4. The changes are so major that CPR+ is allowing customers to upgrade to 8.3 without “getting a life”.

There are more consequenses, but these are enough to indicate that this is a serious upgrade.   When you ask for major change from your software vendor, what do you get?  Major change.  This is not like the interim updates and program fixes that are received throughout the year.  Read the release notes, listen to CPR+, pay attention, invest the time in testing and training and most of all, make sure you “need a LIFE” before you “get a life”.

Rock-Pond Solutions is working hard to stay on top of the changes at the data level.  We are identifying all of our reports that need to be changed and offering new version (no cost) to our customers who need reports that support the new structures.  Our advice?  Be sure and call us before you “get a LIFE”.  You’ll be glad that you did.

Inventory File Integrity in CPR+

The impact of accurate inventory files in CPR+ can not be underestimated.  Inventory drives pricing.  Inventory is the basis for compounding and dispensing.  Key billing codes (therapy types, NDC codes, HCPCS codes, pricing codes, etc.) are set in inventory and carry forward through the home infusion process.  Whether you use the old term GIGO (Garbage In Garbage Out) or more descriptive terms like data accuracy and data integrity, the issue is the same.  The effectiveness of your home infusion company is significantly impacted by the quality of the data in your inventory and pricing files.

Reporting in CPR+ and other home infusion software products often assumes the data is accurate.  Over 50% of the fields in the system do not appear on any report.  The result is you have to view the information on the screen they are entered in or a browse screen such as the grids available in the CPR+ Enterprise module.  This might be sufficient if your data is correct (key word here is “might”) but it will not be sufficient if you have data errors (key words here are “will not”).

Whether you use Rock-Pond Reports or learn to use a report writer to write your own reports, be sure you have reports available that will support your need to validate that the information in your inventory file is accurate as well as reports that alert you when inventory items are added or changed.

AWP Settlement Impact

Do you update your average wholesale prices for drugs each month?  (Correct answer is Yes)  Do you get this information from Medispan or First DataBank?  (99% of home infusion providers will answer Yes)  Do you get a list of drugs whose AWP changed when you run the update?  (Correct answer is Yes)  Was the list of drugs changed on the September 26th update bigger than you’ve ever seen before?  (Probable answer is Oh My God!)

In the aftermath of a class-action lawsuit brought against First DataBank (FDB) and McKesson Corporation by a third-party payor class accusing the two companies of conspiring to inflate the average wholesale price (AWP) of hundreds of drugs, there was a reduction in f AWP values that is one one of the largest single drops in AWP prices on a given day ever.  As 2009 draws to a close, many home infusion providers have not been significantly impacted by this change since their average DSO (days sales outstanding in A/R) is 75-90 days.  However, the impact is coming like a dark cloud on the horizon.  The payers have reduced their AWP prices and any of the contracts that are based on AWP will see reduced reimbursement.   If bills sent in October are typically paid 75-90 days out, the impact is about to be felt most dramatically.

Rock-Pond Solutions is working with providers to analyze the impact based on their payer / therapy mix.  NHIA is working hard to stay ahead of the developments related to home infusion providers.  As a provider you must know the impact the reduction AWP pricing implemeted on September 26, 2009 will have on your company.  You may be in the calm before the storm.  The question is, will you be able to handle the storm when it hits?

Message From Our President

Rock-Pond Solutions is a different kind of company. We understand your home infusion business from the inside out. Our passion is to use our understanding of the data and systems that drive your business to deliver powerful information and business value. Our approach includes a dedicated connection to industry experts, leading vendors and our customers to fuel our learning and development of information products and services. How can we help you?

Regardless of the system you are using, Rock-Pond Solutions will make your company more efficient, more effective and more profitable. We understand the data structures and functionality of CPR+, HomecareNet from Healthcare Automation and Ascend HI from Hann’s On Software as well as anyone outside of these companies. We have excellent working relationships with these three vendors and many of their largest customers. If you run your home infusion business on CPR+, HomecareNet or Ascend HI, we can definitely help you. Contact us today.

Welcome to www.rock-pond.com. Take the time to get to know us. We look forward to the opportunity to learn more about your company and help you maximize your information system investment.

Pete Tanguay, President
Rock-Pond Solutions
501-450-6446
pete@rock-pond.com