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Speedy Meetings

Pete Tanguay — Tue, 31 Jan 2012 23:28:18 +0000

Setting up a new Google calendar, I was in the setup and noticed this setting. How often do I get a meeting request for an hour that is for a subject that could be covered in 30 minutes or less? At Rock-Pond Solutions we strive to be efficient and to produce efficiencies for our customers. This was an ah-hah moment for me. Not really anything new, but a great reminder of how inefficient meetings are and how important it is to cut them short when we can. The next time you schedule a meeting, consider these questions:

Who is coming that we don’t need in the meeting to accomplish the goal?
Could we cover the same material in half the time?
Can we do this over the phone?
Do we even need this meeting at all?
…

You get the idea.

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Medtrade 2011

Pete Tanguay — Mon, 17 Oct 2011 19:58:54 +0000

Get a FREE PASS to the Exhibit Floor if you are a HomeCare Monday Subscriber. Good news is, HomeCare Monday is also Free!!!

HomeCare Monday subscribers can get a FREE pass to Medtrade Exposition Oct. 25-27 if they register for the conference before midnight Oct. 23. The pass to the expo floor is now $50, and this offer will make it free. Go to Medtrade registration and use the code HCMAG. After midnight Oct. 23, all Medtrade admissions increase to onsite rates. Admission to the expo floor jumps to $100, and the conference pass, which is now $199, jumps to $300.

Medtrade is a fantastic place to spend time with the technology leaders of the Home Medical Equipment industry one time a year. Homecare Monday is a great weekly email to keep up with the Home Health Care industry throughout the year!

We recommend them both.

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Accountable Care Organizations & IT

Pete Tanguay — Thu, 19 May 2011 12:21:37 +0000

ACO’s – the latest acronym that is demanding my attention. Accountable Care Organizations (ACO’s) are one of the by-products of the 2010 Health Care Reform law. As with so many “new ideas”, ACO’s are some old ideas under a new acronym, they sound reasonable and they promise something we all are for – lower cost, higher quality health care.

Like so many other new ideas, there is more there than meets the eye and execution / implementation aren’t quite as easy as you would think. “An ACO is like a unicorn; everyone thinks they know what one is, but no one has ever seen one,” says Gene Lindsey, president and chief executive of Atrius Health. “A few months ago, I announced to our organization, ‘We are an ACO.’ “

As I start learning about ACO’s to understand their impact on the home health care industry and the data initiatives and opportunities we are working on, there are a few things for certain:

A lot of money will be spent creating ACO’s long before the cost saving benefits are realized.
Information Technology (IT) will play a central role in the formation, execution and justification for an ACO.
Consultants and attorneys will make a lot of money.
Home health care, with their limited IT budgets and data connectivity (as compared to large health systems) are behind the curve, and possibly more at risk, when it comes to ACO’s.
Where there is change, there is opportunity.

As with other “new ideas” and acronyms, like HIPAA and cloud computing, it pays to take the time up front to understand what is being “sold” and what is required. Take some time to learn how ACO’s impact the home infusion and specialty pharmacy providers in your market area and carefully get involved. Find the opportunity that waits for you, and proceed with caution and with the facts.

Get Rock-Pond Reports on Your Mobile Device

phodge — Fri, 08 Apr 2011 23:13:15 +0000

Dropbox is a great way to bring the convenience of Rock-Pond reports to your mobile devices. When you download Dropbox, you have a folder its developers compare to a “magic pocket.” You store the information from your computer in your Dropbox folder and you can immediately access it from another location such as your mobile device that also has dropbox loaded on it.

Imagine preparing for your weekly management meeting and needing to go through a few reports to understand what is going on, make some decisions and communicate information to people who need it. Instead of everyone printing out reports and heading to the meeting, one person simply runs the reports and drops them in a shared drop box. Everyone (including the people offsite who are calling in to the meeting) simply grabs their iPad and sits down. Everything you need is right there at the touch (or slide) of your fingertips. Need to send a report to someone offsite during the meeting? Simply tap the email icon and off it goes to them.

Need to do some offsite work or have access to reports on the airplane as you travel? No problem. Simply print the report to your dropbox and head out the door. Access the report from your phone or iPad while you are away from your computer. Take the Power of 2 with you wherever you go!

Rock-Pond is focused on providing you with “the information you need from the DATA you’ve got.” With products like Dropbox, you get “the information you need WHERE you need it.”

Dropbox is available free at http://www.dropbox.com for Windows, Mac, Linux and mobile devices.

NEW Deadline for PECOS

lslatton — Fri, 14 Jan 2011 16:32:44 +0000

Once again, Centers for Medicare & Medicaid Services has announced a “placeholder future implementation date” of PECOS. They have set this date as July 5, 2011. Please remember, this date is only a placeholder and could change again. The good thing is that you now have more time to get your PECOS bookkeeping completed with our FREE PECOS Search or PECOS Database Audit!

Check back for more updates – they are sure to come!

Using Windows’ Built-In FTP Client

Matt Lager — Sun, 28 Nov 2010 23:15:34 +0000

Many people are often asked to transfer a file to a remote location using FTP and have no idea where to start, or even what FTP is. FTP stands for File Transfer Protocol and is just that, a way of transferring files from one computer to another. FTP is useful when transferring non-sensitive information to another computer and is widely available on all Windows operating systems. While there are a ton of great third-party FTP clients available for download, most people will find that the FTP client built into Windows will do just fine.

When transferring files to a remote computer via FTP, you will need a hostname or IP address, username, and password. In the following example, the FTP connection information is:

IP Address: 172.16.2.215
Username: ftptest
Password: ****

Anywhere in the Windows Explorer, simply type into the address bar the FTP address you are connecting to as shown below. Of course, replace what’s shown below with your username and FTP hostname or IP address:

Once connected, you will be prompted to login with your password. This will also be case sensitive. Enter your password and press OK. Once you have logged in, you’ll be able to drag files in and out of the FTP server just like you can with any other Windows folder as shown below:

By default, FTP is not encrypted, thus it makes it less than ideal if transferring information that is highly sensitive. Other transfer options exist for this type of data, such as Secure FTP.

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NHIA Data Survey Deadline is November 15

lslatton — Thu, 04 Nov 2010 20:46:31 +0000

Rock-Pond encourages all home infusion providers to participate in the NHIA 2010 Survey.

The National Home Infusion Association (NHIA) has been collecting data from their members for almost a year now and the deadline is drawing near. November 15, is the deadline for getting this survey completed and returned to NHIA.

As of November 4, they have received just over 200 surveys from 26% of their member sites. If you want your company’s data to be included in the survey you have ten days to compile the data, download the Rock-Pond Data Collector, and submit your survey. The survey should not take too much of your time, especially considering the impact the survey could have on current legislation regarding the home infusion industry. Upon completion of the survey, you will receive a complimentary copy of the nation-wide data to compare to your own response.

For more information and to take the survey go the NHIA website.

Rock-Pond Solutions has supported this initiative by developing a FREE Data Collector for home infusion providers. Rock-Pond is a member of the NHIA Data Initiative Committee and believes our collective efforts will make a difference.

PECOS Compliance – Clearly unclear

Pete Tanguay — Tue, 13 Jul 2010 02:19:38 +0000

The following is a portion of the July 12 HomeCare Monday email discussing the current status of PECOS compliance. It’s bad enough that home infusion providers are being held for physician compliance, something they do not have control over, but reading this gave some real insight to the precarious position we are in and the lack of clarity from CMS.

Say What about the PECOS?
BALTIMORE—The question has been asked any number of times now in any number of ways: What exactly is the deal with PECOS compliance regarding DME claims?

The industry’s latest attempt at getting a straight answer came from the American Association for Homecare’s Walt Gorski, vice president of government affairs, on a CMS Open Door Forum July 7.

The background:

The deadline for physician and other prescriber enrollment in the Provider Enrollment, Chain and Ownership System was Jan. 3, 2011, but in order to be compliant with the new health reform law (Affordable Care Act, or ACA), CMS pushed that deadline up to July 6 in an interim final rule.

In a June 30 announcement, the agency said it would “for the time being not implement PECOS edits that would automatically reject claims based on orders, certifications, and referrals made by providers that have not yet had their applications approved by July 6, 2010.”

But the agency gave providers no assurance that, in future audits, they wouldn’t have to give back their Medicare reimbursements based on claims submitted from July 6 to Jan. 3 if the ordering physician was not enrolled in PECOS.

So, AAHomecare’s Gorski asked:

Will [you] address that specific issue, that CMS and its contractors will not seek recoupment from claims that are receiving warnings during this period?

Jim Bossenmeyer, CMS director of provider enrollment, responded this way:

There are a number of reasons why Medicare may recoup money.”

He added that DMEPOS suppliers should:

• Make sure their claims contain the legal name of the physician or other eligible professional along with their Type 1 NPI;
• Make sure the individual is licensed to practice in the state and has not been excluded from the program by the Office of Inspector General;
• Keep documentation from orders for services referred to them; and
• Work with their referral sources to make sure they know there is a requirement for PECOS enrollment.

Gorski tried again:

If we do that and a ZPIC or RAC audit occurs in 2012 and they look and see the effective date of the IFR and see that the referring physician was not enrolled in PECOS, you are telling the supplier community that the money will not be recouped?

To which Bossenmeyer replied:

I have not said that. I understand what you would like me to say, but I cannot give you that answer today.

The comment period for the IFR closed July 6.

At some point,” Bossenmeyer said, “CMS, after we have gone through looking at the public comments, will make a decision regarding the implementation of systematic editing.

One more try from Gorski:

If that is the case, what do [suppliers do if they] get a referral from a physician that is not PECOS-enrolled?

Said Bossenmeyer:

What I’m suggesting to you is that most physicians have an enrollment record in PECOS.” There are 26,000 more physicians and 3,400 more non-physician practitioners in the system’s “pending” file that are currently going through the enrollment process, he added.

“DMEPOS suppliers know the physicians they work with and they know the non- physician practitioners they work with,” Bossenmeyer said. “They should submit compliant claims.

What I’m suggesting to you is that most physicians have an enrollment record in PECOS.” There are 26,000 more physicians and 3,400 more non-physician practitioners in the system’s “pending” file that are currently going through the enrollment process, he added.

With that, AAHomecare reported in its July 8 newsletter, the association “continues to press CMS for clear and unambiguous guidance and is working with providers and patient groups to address our concerns.” And there are a lot of them.

In an eight-page letter sent to CMS, the association formally requested a delay in enforcement of PECOS regulations. The letter reads, in part:

Under the circumstances, it would be patently unfair for CMS and its contractors to reopen claims as a means of enforcing ACA compliance. DMEPOS providers, at best, have only limited influence over what their referral sources do.

More importantly, the IFR offers zero guidance with respect to what providers must do to demonstrate their compliance with the new rules. Although we appreciate the steps CMS is taking to soften the impact of the rule, the potential that providers, whose claims get paid after July 6 but before CMS implements rejections for ordering/referring physicians, will nonetheless be at risk for recoupments based on audits. This will affect HME providers’ cash flow in ways that can be disruptive to patient care.

Consequently, we request that CMS delay the rule and its enforcement until January 3, 2011, at the earliest. Further, because our experience proves how difficult it is to motivate referral sources to comply with these rules, we strongly recommend that CMS publish the percentage of physicians and eligible professionals enrolled in PECOS as of November 30, 2010. If the percentage of providers who are not enrolled in PECOS is greater than five percent of the total number of prescribing physicians and eligible professionals nationwide, CMS should delay the implementation date until this target is met.” Also on the Open Door call, Bossenmeyer said DMEPOS suppliers would not able to use the PECOS system themselves “until the fall of this year.” CMS had previously said the system would be open for DMEPOS enrollment in July.

Rock-Pond Solution’s PECOS Database Audit Tool is one way to assess your risk and do something about it NOW.

CMS Physician Registration Compliance

Pete Tanguay — Thu, 01 Jul 2010 12:24:08 +0000

Any physician who refers or orders services (DMEPOS, home health, specialist services [not defined by CMS], lab, or imaging) will need to be enrolled with Medicare in the Provider Enrollment, Chain and Ownership System (PECOS) by July 6, 2010. This includes any physician who has not submitted an updated enrollment application to Medicare since November 2003 or has had a change to their enrollment information during this time but has not reported the change. If physicians are not enrolled by July 6, the physicians who they refer patients to could see their claims reject. This enforcement goes beyond what is in the new health system reform law which says that by July 1, 2010, all physicians who refer/order home health and DMEPOS must be enrolled. The law does allow for the Secretary to require physicians who order/refer other services to be enrolled later, but CMS has decided to require them all to be enrolled in PECOS by July 6, 2010.

Earlier this year, the compliance date had been delayed to January 3, 2011. Physicians and other providers should not delay in verifying their current PECOS enrollment as the enrollment process takes about 45 days. To verify current PECOS enrollment, contact WPS Medicare enrollment at (866) 503-7664 or check the “Medicare Ordering and Referring File” periodically updated on the CMS Web site.

What this means for home infusion providers is:

They must identify on an ongoing basis which of their physicians who refer Medicare patients are not in the PECOS database.
The new physician process needs to be changed to add the step to check the CMS website to determine if the physician is registered.
A process needs to be put in place to contact the physician if they are not registered.

Rock-Pond Solutions has added a PECOS database audit service to do a physician file audit with a 24 hour turnaround to assist providers in determining their physician compliance and minimize the financial risk of denials.

The following is a sample letter that might be sent to a physician to request them to register in the PECOS database.

Dear Dr. XXXXXX:

By now you have likely heard of PECOS. PECOS (the Provider Enrollment, Chain, and Ownership System) is a comprehensive healthcare provider database maintained by the Centers for Medicare and Medicaid Services (“CMS”).

On October 5, 2009, Medicare contractors began validating referring physicians referenced in claims for reimbursement for durable medical equipment against PECOS to ensure that only those physicians qualified to prescribe DME are doing so.

Currently, these validations result in warnings to the DME providers; however, on July 6, 2010 claims will be rejected if the referring physician’s information is not found in the PECOS database. It is important that your information in PECOS is complete and accurate so that your patients’ DME equipment is eligible for reimbursement after July 6, 2010. It is ESSENTIAL that your information is complete and accurate to ensure your patients receive the necessary supplies, medications, and equipment required for their care at home.

Attached please find a basic guide for accessing and updating your PECOS information in the CMS database. If you have not yet registered and would like more detailed instructions in how to complete this process, please contact our office at (XXX) XXX-XXXX. Thank you in advance for your business.

Regards,

Name
Title

Patient Pay Accounts – measure & manage them

Pete Tanguay — Mon, 17 May 2010 17:28:38 +0000

Too often we measure the results of our staff by the wrong measures. This is a disservice to our staff and a liability to our business. The more we measure based on absolute numbers that are indicators of the business results we are looking for, the more satisfied our staff will be and the healthier our business will be.

Consider the patient pay collection process. The process is simple

Transfer the balance to the patient.
Contact the patient to set up a payment plan (payment in full or monthly payments).
If the phone does not work, use certified mail.
If the patient won’t pay, escalate the notices you send or transfer to collection.
If the patient is still active, collect the amount on the next delivery.

How do you measure this process?

The number of calls made
The number of patients contacted
The number of payment plans set up
The number of accounts sent to collection
The percentage of patient A/R to total A/R

Reimbursement management needs to know the amount of time is being spent on patient collections and the results that are coming in from these efforts. You must know the costs you are incurring to collect the accounts and the money you are collecting as a result. If you don’t, the effectiveness of your patient pay process is a guess at best and you may be chasing a $10 bill with $100.

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