Rock-Pond Solutions - Home Infusion Software Reports, HME, Hann's, CPR+, Fastrack» CPR+ & Mediware Customers

Focus on therapy / payer mix for profitability

Pete Tanguay — Fri, 03 Feb 2012 23:54:58 +0000

From a financial and profitability perspective, all patients are not equal. The two primary drivers of profitability in a home infusion business are therapy and payer. In order to manage your business to drive profitability, you must understand which payer / therapy combinations are “good” business and which ones are not.

As a general rule there will be 6-8 focus therapies that if you do well with those, you’ll do well as a company. These are therapies like TPN, IVIG, etc. These may be unique to your specific business focus. There are other therapies like hydration and catheter care that you will do but are supplemental to the focus therapies.

Not to mention any names, there are some payers that are typically good and others that pay poorly and late in almost all cases. However, there are many cases where a specific payer / therapy combination is an exception to the quality of the payer. Often, for example, providers dismiss Medicaid as a poor payer. This is not always the case. There may be therapies that your state Medicaid payer recognizes for the value they provide and will pay for them comparable to private insurance.

Rock-Pond Solutions wrote a custom report for a large provider who had identified their focus therapies and wanted to provide their sales team with feedback regarding the quality of the business their referral sources were referring to the company. Instead of Good / Bad business, they opted for Good Revenue and Low Revenue as the two categories. The report has the option to run based for new patients (patients where the start of care date and dates of service are in the same month) or all patients. Providing this feedback to the sales team on a weekly basis gave them immediate feedback on the value of the referrals they were receiving from the physicians and referral sources they were meeting with. In turn they were able to direct their sales and marketing efforts to drive more Good Revenue in to the business.

Not only did the sales team improve, but the profitability of the business overall improved significantly. Simply focusing on key therapies, payers who paid poorly on these key therapies and the source of these referrals was the start. Providing this information to the sales and clinical team so everyone knew the difference between Good Revenue and Low Revenue was the key to improving profitability.

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Can Rock-Pond recreate the report from my existing software?

leah — Tue, 31 Jan 2012 17:49:23 +0000

Are you tired of running reports on multiple reporting platforms? Do you wish that the report in your existing home infusion or HME software had a new function? Is there formatting issues with the report you’d like to resolve? If you have ever asked yourself one of these questions, more than likely you have wished that a report you use in another program was accessible in the Rock-Pond Information Center. Reports are our specialty and we would be glad to create an enhanced version of an existing report for you. And you won’t have to wait for the next release of your software system to have it available to use.

A home infusion provider and Rock-Pond customer recently called regarding the Physical Inventory Report they planned to use for year-end inventory counts. The report they used in CPR+ had formatting issues that would not be resolved until the next software release at the earliest. They were on a tight year end schedule and this would increase the time and labor it would take to complete the physical inventory count. They turned to Rock-Pond for the immediate solution and within 24 hours, Rock-Pond added an enhanced Physical Inventory Report to the Rock-Pond Information Center for them to use. The new report had the same information as the CPR+ report, but due to some minor formatting changes, the report was an impressive 60 pages shorter for one location and fit their inventory count process perfectly!

With Rock-Pond, you are free of the inefficiencies of running reports on multiple platforms. You can get a report exactly how you want it without having to invest in report writer resources within your company. It is no only okay to want a Rock-Pond Report instead of the report you already have in your existing software, it makes good business sense. We understand how sometimes the smallest change can make the biggest difference to an organization.

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Competitive Bidding – know your software

Pete Tanguay — Wed, 04 Jan 2012 13:35:52 +0000

The three primary reasons your software vendor charges you a maintenance fee every month are to add new features to support your business, take advantage of changes in technology and to keep up with regulatory changes. One of the best ways to get the most for your money and to leverage your software investment is to upgrade to new releases and more importantly to integrate the features into your business.

I was reminded of this when I saw the information about the CPR+ Competitive bidding webinars provided as part of their free monthly training.

Rock-Pond Solutions has joined forces with the Med Group to help HME and Infusion providers get ready for competitive bidding. We have delivered reporting solutions that provide the information providers need to determine whether to submit a bid, how to price their bid and analyze the impact on their business if they are awarded (or not awarded) the bid for a specific category.

This is just the beginning. You must also commit to learn how your software will help you during the new patient, order entry, delivery and billing process. You need to understand how your software enables you to set up your competitive bidding categories, manage the patient intake and billing process for Medicare patients based on type of service and zip code. This will improve your efficiencies and insure your claims are priced accurately.

You will find this information in the release notes published by your software vendor as well as through vendor training. For example, last year CPR+ added competitive bidding features that automatically identifies patients receiving service in competitive bidding areas, determines when competitive bid single payment amount is used, and prevents customer service representatives from inadvertently supplying items for which the provider will not be reimbursed. CPR+ provides monthly training for free that will help you know how to integrate features like these into your business. One of the sessions in January will help you learn how to use these features.

With Mediware HME solutions you can also seamlessly bill according to Medicare’s new Competitive Bidding requirements. The system comes pre-loaded with the designated Competitive Bidding Areas, the additional product categories, and all of the Medicare pricing to make order entry and billing simple and efficient.

Regardless of what software you use and how well they stay up to date with change in the industry, technology and regulations, it won’t matter unless you make a commitment to KNOW your software and INTEGRATE its features into your process.

Getting the data in correctly and most efficiently is the first step to efficient operations. When you do this you can count on Rock-Pond Solutions to help you turn all of this data into the information you need when you need it. We are also committed to keeping up with the industry, technology and regulatory changes.

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Competitive Bidding Update

Pete Tanguay — Fri, 23 Dec 2011 18:55:49 +0000

Questions are rolling in from providers about how to get the material needed for bid submissions. Rock-Pond wants you all to know that the competitive bidding process does not have to be a nightmare! We have it covered. Rock-Pond Solutions is actively working with The MedGroup and MHA to fully understand the impact of competitive bidding on the home infusion and HME industries. Rock-Pond Reports customers and MHA members with the MHA Business Solution Center have a powerful report to give them the information they need to complete Form B in the CMS Competitive Bid process.

“The Rock-Pond Competitive Bidding report went beyond providing my revenue by zip code. It already had the competitive bidding areas (CBA) defined so I could easily manage my Medicare and non-Medicare revenue grouped by these CBA’s. This saved me a tremendous amount of time in completing Form B in the bidding process. “ Hospital Based Home Infusion Provider

Our reports utilize the data in your CPR+ or Mediware software to produce the powerful and accurate information necessary for these submissions. To view the Rock-Pond Report for your system, click below:

CPR+
HomecareNet
Ascend – not available at this time. Email us if you are interested in this report and we will get this done for you.

Do YOU have tough questions about Competitive Bidding Round 2? Contact us and we will help you find the answers to these questions. We will provide you with the Competitive Bidding information you need from the data you’ve got! For more information about questions to ask before and after you bid, review this post from September 2010.

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Unlimited Reports at the Same Time

Pete Tanguay — Wed, 07 Dec 2011 21:08:42 +0000

One of the challenges of traditional software reporting is running a report literally locks up your system.

Have you ever been viewing a report and someone asked you to look something up for them? Let’s say you are analyzing claim denials and a patient calls with a question about their account. To answer their question you have to close your report, look up the information for them and then rerun the report and try to remember what page you were on.

The Rock-Pond Information Center solves this problem. Each time you run a report it opens a new instance on your task bar allowing you to run as many reports as you want, run one report as many different ways as you want and use any other program you want, including CPR+, HomecareNet or Ascend, without closing your report or losing your place. When you think about it, this design feature alone might improve the productivity of your staff and pay for your investment in Rock-Pond Reports. The hundreds of reports that give you powerful information you are not able to get from your system will be a bonus!

At Rock-Pond, we are dependent on the Rock-Pond Information Center to get the information we need from many different data sources. I noticed how many reports I had open on my desktop and realized how much I relied on this feature. If your system can’t do this, you are missing out.

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Competitive Bidding Round 2

Pete Tanguay — Thu, 29 Sep 2011 11:37:18 +0000

Competitive Bidding Round 2 is in full swing. Providers in the affected areas of the country are in the bidder registration process if they are going to submit a bid. Rock-Pond Solutions recently gathered with a group of home care providers at the Mediware Conference to discuss the impact on their organizations and offer some strategies for working through this process. Rock-Pond has assisted providers in Round 1 with CMS reporting requirements and has expanded our reporting offering to assist in the round 2 process as the number of services covered has expanded.

The following are some questions to ask during the process. Our Rock-Pond Reports product has the reports you’ll need to get the answers to these questions. As always, you’ll be able to pull these answers directly from the data in your CPR+, HomecareNet, Ascend or Caretinuum software.

Pre-Bid questions

Should I register to submit a bid?
What is the financial impact if I do not get the bid?
What price should I bid
What is my mix of Medicare patients in the CBA’s I service for the services covered by Competitive bidding?
What other services (non-competitive bidding) are these patients being provided?
What referral sources will be impacted

Post-Bid questions

Changes to the intake processes
Changes in the pricing and billing processes
Reporting requirements to CMS
Ongoing business analysis on the impact of competitive bidding

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Synagis and your DSO

Pete Tanguay — Fri, 23 Sep 2011 12:08:47 +0000

It’s “Synagis Season” again for many home infusion companies. As a clinician it’s “no fun” to see such sick kids and as parents there are financial challenges as well when their insurance coverage is inadequate or unavailable. The cost and low profit margin on the drug requires that a home infusion company pay attention to this area of their business, during this season.

Consider the impact of a seasonal, high priced service such as providing Synagis on your DSO. If you are not careful you’ll be caught off guard at the end of the season and here is why.

Days sales outstanding (DSO) is a calculation used by a company to estimate their average collection period. The formula to calculate it is your Accounts Receivable balance / average daily sales for a period, usually 90 days. If your A/R is $1,000,000 and for the last 90 days you’ve generated $1,000,000 in revenue (or $11,111/day), your DSO is 90 days. The lower your DSO, the faster you are collecting your money and the more bragging rights you have with other providers.

High revenue seasonal services like Synagis can lower your DSO. What’s wrong with this? We want a lower DSO, right? Absolutely, but you must be careful that you don’t take your eye of the non-Synagis portion of your business. Let me explain.

Any time you have a spike in revenue, especially when it is a service like Synagis that you can get paid for rather quickly if you are doing a good job in your billing area, you’ll see your DSO go down. Why? Because your sales are going up fast and the money from these sales is coming in quickly. The reimbursement staff is excited because the company DSO has gone from 73 to 48. This is great because it usually happens around the end of the year, about 3 months into Synagis season. The bad news comes when Synagis season is over, the revenue stops and you are left with A/R that is old, A/R that you have not paid attention to as you should have and A/R that is harder to collect. Spring is turning into summer and your DSO is 94.

The best solution to this is to manage your DSO by payer, therapy and biller/collector to make sure you see the entire picture and can addresses issues quickly. Carve out special business situations like Synagis season so you don’t lose focus of the rest of your business. Use the A/R Analyzer, Revenue Analyzer and Profitability Analyzer reports in Rock-Pond Reports to make sure you see the entire picture and keep your business on course through change.

Rock-Pond solves Tough Problems

Pete Tanguay — Thu, 22 Sep 2011 15:42:55 +0000

We’ve always thought of our company as the DATA company. Our customers and others in the home infusion industry often refer to Rock-Pond Solutions as the REPORT company. Our customers use Mediware and CPR+ software and we help them get the information they need out of the data they’ve got. That’s what we do best and it’s what separates us from the rest.

As we’ve put together a new marketing plan we’ve come to realize that more than writing reports and delivering the INFORMATION YOU NEED from the DATA YOU’VE GOT, Rock-Pond is a company that helps people solve tough problems. We looked at the history of our company and the tough problems our industry has faced during this time. It’s the tough problems these reports have helped to solve that has brought us to where we are. Rock-Pond Reports, delivered through the Rock-Pond Information Center delivers exponential power (The Power of 2) when used in conjunction with your pharmacy dispensing system.

Over the next few months, we’ll be putting together some case studies and information about how Rock-Pond can help you solve the tough problems you face. For now, here’s a brief history of where we’ve come from in the context of the timeline above.

Brief History of Rock-Pond

In the early 1980’s the movement know today as the home infusion industry began. Over the past 30 years medical and technology advances have enabled this industry to become what we have today. Rock-Pond, in a sense, has been there since 1987 when Pete Tanguay (I) started the development of the first comprehensive home infusion software product for I Care of Arkansas, Dr. Gene Graves’ company. Dr. Graves was the founding president of the National Home Infusion Association (NHIA) and in 2005 he was the first recipient of the Gene Graves Lifetime Achievement award to honor individuals who have made outstanding contributions to the home infusion therapy community.

MBI was sold to Option Care in 1996 and in 2000, Pete Tanguay left to start Rock-Pond Solutions. Through this time, the industry has faced many challenges and changes as we do today.

Over the years, the home infusion industry has gone through a lot of change. Many of you remember these changes and the challenges they posed. Through all of these changes, companies who had the information they needed had a tremendous advantage.

Rock-Pond Solutions is well positioned to leverage our experience and the information tools we’ve developed to help you get where you need to go no matter what obstacles or opportunities you face.

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Timely Filing – Submitting the claim is not enough

Pete Tanguay — Wed, 18 May 2011 03:40:44 +0000

Working in the home infusion industry since 1987, I’ve seen a lot of things that were hard to believe. One day I watched a billing clerk sit and write off claim after claim with absolutely no emotion. I asked her why she was writing them off instead of billing them and she said, “because I can’t bill them. I don’t have an authorization and the time limit to submit the claim has passed.” Within 6 months this hospital based home infusion was closed and sold to a national home infusion company.

Years later we wrote a report for a very progressive company that had a zero tolerance for timely filing denials. Their process was to validate that every claim was not only submitted, but also received prior to the filing deadline. Most people think of timely filing as the number of days a provider has to submit the claim to get it paid. I learned from this customer that when a claim has been submitted, but not verified as received, the claim was still at risk for a timely filing denial. To meet a zero tolerance objective on timely filing denials, you must have a process in place to identify claims that have been sent but may not have been received and contact the insurance company or resubmit the claim.

The following is a proven process, utilizing Rock-Pond Reports to give you the information you need.

Establish a zero-tolerance policy for timely filing denials.
Run the Rock-Pond A/R adjustments for the last year by payer within adjustment reason and review all of the claims denied because the timely filing deadline had past. This will tell you the extent of your problem.
Identify the most common timely filing deadline for your insurance companies, most likely 90 or 120 days.
Identify all insurance companies whose timely filing requirements are less than or greater than this number of days. Load the timely filing deadline for these companies in your insurance tables.
Using the Rock-Pond Unbilled Report for claims within our X days of timely filing, work the claims to make sure they are submitted, even if they will be denied for some reason. You can resubmit a claim denied for lack of authorization but you can not submit a claim you didn’t file in time.
Once claims are submitted, follow up to see that they are confirmed as received and record a billing note with the receipt validation. This can be through an electronic claim response file or talking to someone on the phone.
Using the Rock-Pond Claims in A/R that are within X days of timely filing, work these claims by calling to verify receipt or resubmit the claim. The report will show all claims that are within the timely filing limit and have not had a payment, adjustment or note posted.
Enforce your no-tolerance policy for timely filing denials.

One of the main problems with standard procedures used to manage timely filing collections is people typically assume if you sent out the bill you will not get a timely filing denial. Adding the management of sent claims to your timely filing process will help you identify claims you think you have sent but have not been received and get you closer to your zero-timely filings.

Rock-Pond Solves Timely Filing Problems

phodge — Wed, 18 May 2011 03:10:42 +0000

Submitting a claim by a payer’s timely filing deadline is essential to running your business successfully. If you submit your claim late, the payer will deny payment on it. Rock-Pond can help you avoid this problem with their timely filing reports for HomecareNet and CPR+.

These reports recently made it much simpler for a Rock-Pond customer who uses the CPR+ system to submit claims in a timely manner. Rock-Pond’s timely filing reports gave them a list of timely filing deadlines for their active insurance companies and gave them detailed reports that showed their unbilled tickets and invoices in their A/R with the reason it hadn’t been billed and the amount expected from each claim.

The company’s director of operations said that while CPR+ has some good tools, the Rock-Pond reports she uses gives her greater detail that allow her to group her information how she needs it.

“CPR+ is great because it will highlight in red if something is timing out, but [the Rock-Pond report] will tell you exactly how much time you have and I think that’s so much better,” she said.

Thanks to Rock-Pond, this customer was able to gain access to the information she needed from the data she had and automatically analyze how her company was doing with filing claims in a timely manner. If you’ve had a similar success with these reports or would like to know more about becoming a Rock-Pond customer in order to take advantage of these reports and many others, contact Rock-Pond today.