Medforce Blog

HME Billing Software Trends

A Q&A with CEO Esther Apter

June 02, 2016

Category: General

Billing systems have advanced greatly over the past few years and their capabilities have expanded beyond just billing. Are HME companies utilizing the functionality and scalability that today’s systems provide?

One of the biggest challenges we see is when HME providers look to their billing software to be everything to everyone. What they hope will be a silver bullet ends can end up leaving much to be desired in one area or another.  While there is a convenience factor associated with an all-in-one technology, the flip side is that they typically lack modifiability and flexibility and usually contain only a subset of possible functionality.

A best-of-breed approach can help providers ensure their organization’s specific strategic priorities are addressed. They should assess their needs and select the best fit for each and tie them all together - the best inventory management, the best A/R analysis, the best document management, and the best process management. In a business environment that is growing more complex, using this type of strategy can help build confidence and save frustration. With a growing emphasis on interoperability the ability to build a seamless, customized system is easier than ever.

All too often we hear of providers learning from the billing software companies themselves what the most important features are. We strongly believe providers should come to the table with a check list of their needs and priorities and make sure whatever software products they purchase can live up to expectations. The best customers are informed and empowered customers.

With interoperability throughout the healthcare continuum making progress, how does HME fit into the picture? Should they be receiving EHR information in their administrative process and have the ability to share it with other providers? Why or why not?

Most HME billing systems don’t share data effectively, especially ones that are focused on building a bundled/all-in-one solution and don’t consider that clients might want to go outside their umbrella for a component of their system. Often they will push information out, but most do not effectively receive information.

At Medforce, we believe strongly that it should be the client’s choice which software they use and what data they need. No two businesses are exactly the same. The provider’s needs should be met by opening the door and exchanging data with whomever the client wants to work with. The provider should be able to choose who they consider to be the best credit card processing service, the best clearinghouse, the best document management, and so on, and not be limited to the vendors the billing software has selected for them.

Interoperability should be client-centric, driven by the needs of the providers to fulfill their missions in the most efficient manner possible. It shouldn’t be up to the software providers to decide who they will and will not integrate with. We believe every system should be built to share information at the customer’s request. This is better both for the providers and for patients. In this scenario of open (secure) data sharing, each software developer can focus on promoting what makes it the best and isn’t holding customers hostage.  As long as the connections are secure, data should flow freely regardless of who is sending or receive it.

With regard to data and predictive analytics: How are billing systems creating and accepting data from other devices and software to allow providers to conduct analytics in their billing systems? How can this data help providers better manage their businesses and position themselves as a strong partner to referral sources?

The data stored in a billing system is just one piece of the puzzle for HME providers looking to optimize their operations. Typically, billing systems come with a stock set of reports, which might not fully align with the information needed to best manage operations and custom reporting is difficult or costly to create.

When billing software is the only central place be where the business analytics takes place the data is limited to what is in the billing software. A business process management (BPM) platform, like Medforce’s CommandCenter, can act as a backbone for an entire organization, gathering data from and connecting disparate business applications – from intake to order management, inventory, fulfillment, claims, audits and beyond.  It creates comprehensive reporting at the click of a button that provides predictive analytics and actionable insights. You can look at not just top line numbers, but actual productivity throughout the organization to identify bottlenecks, duplication of effort, wasted effort and other opportunities for process refinement. BPM makes business analysis centralized, visible, and easily manageable, and it creates accountability. The ability to easily drill down on the data behind the reports to truly get to the root causes allows you to make appropriate changes in your operations and track progress.

There’s been a lot of consolidation in this space over the last two years. What impact, if any, is this having on providers? Is there enough choice of technology in the market for providers?

Consolidation isn’t necessarily a bad thing on the surface, but it is something providers should be wary of. It limits market competition and options. In some cases, we see growth by acquisition result in the sunsetting of software that providers have become reliant on for the purposes of pushing the software developer’s strategic agenda.  Larger organizations are known to move more slowly, and this could impact the R&D that is critical to keeping a technology on the leading edge and the tech support that is vital to keeping a positive user experience on a day-to-day level. Further, consolidation also should not be confused with integration – two pieces of software sold by the same company will not necessarily have a seamless operating experience if they were brought together by acquisition. 

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