Products & Technology Annual Software Roundup

A Foundation for Flexibility

Software resources to help providers quickly respond to changes in the future and in the here and now.

• By David Kopf
• Nov 01, 2011

Providers find themselves in the impossible position of having to make sense out of uncertainty. When looking ahead to the coming year or so, Round Two of competitive bidding’s shadow looms large over everything.

But the shape of that shadow is one that constantly shifts. While Round One of competitive bidding has provided some lessons as to how Round Two will play out, the industry has never seen anything of its scale. The change will be massive, and to what extend and in what ways is anyone’s guess.

This is exactly why HME software is so important. Software lets providers pivot more quickly in response to change, so that they can drive new efficiencies and cut costs in ways that best conform to whatever funding cuts will come from Round Two. (In fact, cutting costs to drive profitability is the name of the game for just about every sector of the game, no matter what happens with competitive bidding.) HME software can help providers not only pare for competitive bidding, but also plan their businesses, and then alter those plans, as Round Two comes into sharper focus.

Moreover, providers face tough challenges in the here and now, such as CMS’s pre- and post-payment audits. Software can help implement the business and documentation practices that will help protect providers from audits, as well as help ensure the right documentation is easily accessible in cases where audits occur.

So, for this year’s annual HME Business software roundup, we’ve decided to examine the various features that help providers implement that kind of “strategic flexibility” that can help them plan for and respond to still-evolving changes and challenges. Bearing that in mind, here are the features we felt important to survey from the various software manufacturers:

• Audits
  Features that help providers prepare for RAC, CERT, ZPIC and other pre- and post-payment audits.
• Competitive bidding
  Tools that help providers better prepare for Round Two of competitive bidding (or similar market-based approaches for setting Medicare reimbursement rates).
• Claims/Billing
  Billing tools, authentication, and processing features.
• Reporting/Executive View
  Reporting tools and “executive overview” or “dashboard” features to help owners manage their businesses.
• Customer contact
  Tools for automating customer contact, such as IVR and automatic email notification.
• Inventory Management
  Control and tracking capabilities such as barcoding, scanning, and automatic reordering.
• Handheld Devices
  Support for handheld devices for delivery and other field personnel to increase their efficiency.
• Delivery Management
  Tools for planning and optimizing routes, as well as for tracking vehicles.
• Workflow
  Ways to help providers implement more streamlined and efficient workflows.

AR-Express

DIABCO – Healthcare Software Solutions
http://www.ar-express.net/
(800) 864-6210

Year’s company has been in business: 30
Number of installed systems: (not available)
Type of System: A stand-alone system installed on-site
Software programming languages and database environments used: Microsoft Windows 7, Server 2008, MSQL 2008, .net, VB, VFP

Features

Competitive bidding: Patients are automatically identified as living in a Competitive Bid Area when demographics are input.

Claims/Billing: AR-Express features electronic billing for all primary and secondary insurances, including MSP. A table-driven set of business rules lets users define payor-specific validations of claims for the claim scrubbing process. Prior to claim processing, Medicare benefits can be confirmed using ME-First, DIABCO’s web-based eligibility service, which identifies HMOs, deductibles, and correct addresses.

Reporting/Executive View: The Report Manager enables users to create new reports, or edit any of the 200 existing system reports. All of the system reports can also be ‘printed’ to an Excel spreadsheet and modified with this Microsoft Office tool. The ‘DashboardME’ automatically measures, monitors and analyzes daily processes.

Customer contact: Review+Link enables users to review and process paperless faxes received, and then link them to individual patient records in the AR-Express Billing System’s database. It reduces printing and copy costs while organizing workflow more efficiently.

Inventory Management: The purchasing and receiving process updates inventory onorder, on-hand, and last costs for all products by manufacturer, and can produce bar coded price tags. Using the ePO feature will send purchase orders electronically to vendors. As patient orders are entered, inventory is depleted and stock status reporting gives providers a reorder tool.

Handheld Devices: AR-Express is compatible with most handheld scanner systems. Patient account number, item number, and asset number all print in barcode font.
Delivery Management: Barcoded delivery tickets and products are used to capture all outgoing delivery information using handheld barcode scanners. Barcodes are also used for retail sales with DIABCO’s POS-Success system. Even patients can be given barcoded “customer loyalty” cards for promotional purposes

Workflow: AR-Express offers STEPS which help users to keep track of documentation required before billing. Mutipule reports are available to manage claims throughout the billing process. Electronic payment posting is included.

Brightree software

Brightree LLC
www.brightree.com
(888) 598-7797

Year’s company has been in business: 10
Number of installed systems: 1,650
Type of System: A hosted, web-based/SAAS system
Software programming languages and database environments used: built using Microsoft’s .NET framework and MS SQL Server for its database environment.

Features

Audits: Brightree provides systematic workflows that guide users to proactively gather thorough documentation on the front end. Brightree automates manual tasks, directing employees through the complete process. Providers can track changes in the system by user; automate eligibility to avoid delivering products to ineligible patients; use Brightree electronic fax and document imaging to quickly document CMNs and doctors’ orders to the patient record for future reference; and produce tracking and trending reports that can help providers monitor their business and compliance.

Competitive bidding: Brightree’s automation and business insight tools are proven to help providers increase efficiencies by 30 percent or more and at the same time increase cash flow. Brightree’s Product Profitability Analyzer can help providers determine inventory mix by calculating profitability at various reimbursement rates. Results can be summarized by product category or detailed by HCPCS code. Brightree’s Executive Dashboard tracks trends from intake to invoice to highlight operational processes. The Business Scoreboard provides a snapshot of key performance indicators like asset utilization and DSO.

Claims/Billing: Brightree automates all aspects of billing workflow. Features include electronic claims processing and automated alerts that allow billers to focus on exceptions in submission, rather than spending time preparing and submitting batches; streamlined rejection and denial management, offering opportunities to analyze the data for improvements in intake and billing processes so as to avoid delays in reimbursement; electronic processing of secondaries and posting of ERA payments to help improve cash flow; both real-time and batch eligibility to enable verification for recurring rentals and supplies; and same or similar verification to reduce denied claims by delivering only products that are reimbursable.

Reporting/Executive View: Brightree generates reports that provide visibility into the key performance metrics of your business. Brightree’s Business Scorecard provides updates on nine Key Performance Indicators with drill down capabilities. The Executive Dashboard looks at business trends in a graphical format. Brightree’s ad-hoc reporting system is also part of the core Brightree solution. These reports can be run in both PDF and excel formats.

Customer contact: Brightree Interactive Voice handles routine reorders and generates alerts for live customer contact and important administrative actions, allowing providers to more effectively use staff resources. Because it is fully integrated in Brightree, it is highly configurable, and campaigns can select criteria based on real-time patient data, eligibility, payers and more. Our integrated solution eliminates redundant workflows and rekeying errors and increases the percentage of successful connections.

Inventory Management: Brightree’s integrated ordering and inventory tracking maximizes inventory turnover, tracks repair and maintenance and fl ags obsolete and superseded products. Brightree supports handheld scanning devices to quickly and accurately count inventory items. Our Integrated ePurchasing with major suppliers enables seamless and accurate ordering from within the Brightree system. When Integrated ePurchasing is combined with drop shipping, providers can reduce delivery charges and inventory carrying costs.
Brightree works in real-time, so that when shipments are received they are immediately refl ected in inventory.

Handheld Devices: Brightree’s Mobile Delivery Management system improves drivers’ productivity by equipping them with industry-standard mobile devices that synch with Brightree data in real time. Brightree’s wireless integration enables drivers to transmit delivery information so it is immediately available to billing staff. The handheld mobile units also incorporate a GPS, keeping drivers on schedule and maximizing the number of deliveries per truck.

Delivery Management: Brightree Mobile Delivery Management (MDM) enables drivers to reduce lost paper tickets, expedite routing, and improve documentation. When combined with document imaging, it automatically files the signed delivery ticket into the patient record, eliminating the need to manually scan documents. Serial numbers and lot numbers can also be scanned when delivered or picked up. With MDM, inventory, maintenance and billing records are immediately and correctly updated, reducing DSO.

Workflow: Brightree automates the HME operation from intake through collections.
Examples include: automated electronic claims; tracking work in progress to monitor order status and identify bottlenecks; ERL management through an online central work queue; and individual tasks and alerts on each user’s home page to guide the process to completion.

CPR+ for HME

Definitive Homecare Solutions Ltd.
www.cprplus.com
(866) 277-4876

Years company has been in business: 18
Number of installed systems: 650 systems/1,100 sites
Type of System: A stand-alone system installed on-site
Software programming languages and database environments used: C#, ASP.NET, Microsoft VFP; Database: Microsoft SQL Server

Features

Audits: With claims holds and Medicare setup, CPR+ provides tools to ensure that HME providers have met Medicare requirements to better withstand audit scrutiny. With integrated document imaging and filterable claims reports, CPR+ for HME empowers providers to answer audits inquiries efficiently.

Competitive bidding: CPR+ provides profitability reporting to allow HME providers to prepare bids by product category, and CPR+ handles the complexities of providing services in a competitive bidding area. With alerts when a patient is in a competitive bidding area and automated reimbursement rates to apply competitive bid rates, CPR+ ensures that customers never provide a product or service that won’t be paid for.

Claims/Billing: CPR+ includes real-time and batch insurance eligibility checks, allowing HME providers to instantly check eligibility for new patients and batch checks grouped by payer and/or product and service types to insure continued eligibility for recurring supplies patients. CPR+ includes contract setup tools to address Medicare and every commercial payer requirement, including items covered/not covered, special coding requirements, and item substitutions.

Additional features: holds for supporting documentation/authorizations with automatic renewal tracking, front-end edits for electronic claims, batch re-submissions, eligibility checks for Medicare and Commercial, batch balance write-offs, and an A/R Manager for a single-screen, filterable work list for all or any portion of accounts receivable.

Reporting/Executive View: CPR+ provides an Executive Summary Report, daily statistics dashboard, and a web-portal dashboard to provide dashboard business metrics from anywhere, as well as a host of customizable reports in the CPR+ Report Library. CPR+ provides instant visibility to workloads and bottlenecks through CPR+ Enterprise.

Customer contact: CPR+ automatically tracks patients receiving recurring supplies orders, organizing the outbound calling process. With its open SQL database, providers can export recurring supplies patient data to any IVR system. CPR+ also makes it easier for patients to initiate requests for re-orders through the CPR+ Web Portal which provides patients with anytime, secure access to information about pending and prior orders and easy re-order requests.

Inventory Management: CPR+ provides barcode-based inventory management for receiving, purchasing, and physical inventory. It extends barcode inventory management in the field to provide delivery technicians with the ability to assign equipment and serial numbers at the point of delivery. Additional features: tracking across multiple inventory locations with par values to maintain efficient inventory counts.

Handheld Devices: As part of its suite of automation tools for HME providers, CPR+ for HME includes fully integrated delivery management features, deployed in the field through EDA devices using our exclusive Delivery Plus software. With CPR+ for HME and Delivery Plus, HME providers can provide delivery information and directions to drivers on EDAs; add new deliveries to in progress routes; assign serial numbers and edit and confirm delivery tickets in the field; eliminate the delay from delivery completion to billing; and capture patient signatures in the field.

Delivery Management: CPR+ for HME offers a fully integrated delivery management system with a route manager to group deliveries, assign and optimize routes. When used with Delivery Plus on handheld devices, CPR+ provides real-time GPS tracking with instant delivery confirmation, allowing billing seconds after delivery.

Workflow: CPR+ Enterprise organizes the entire process of an HME provider into an efficient queue-based system. With its one-screen enterprise-level view, managers can spot bottlenecks in the process instantly.

Fastrack Enterprise System for HME

Fastrack Healthcare Systems Inc.
www.onlyfastrack.com
(800) 520-2325

Years company has been in business: 18
Number of installed systems: 1,103
Type of System: A stand-alone system installed on-site, or a hosted system, that uses special client software Technology
Software programming languages and database environments used: Microsoft SQL

Features

Audits: Fastrack provides the necessary audit reports and data capture to help ensure the provider is in compliance and can respond appropriately to an audit. Especially helpful is the Fastrack Electronic Patient record including the integrated Document Management system that provides easy access to the complete patient record.

Competitive bidding: Fastrack Business Intelligence and our reporting system will help providers analyze their cost and profitability for purposes of submitting a bid. The system will automatically alert the user to prevent product being provided to patients in competitive bidding areas, which the provider is not eligible to supply.

Claims/Billing: Fastrack is 5010 compliant and provides direct on-line claims submission to Medicare and Medicaid, as well as to over 2000 commercial carriers through Emdeon and Zirmed. Fastrack offers on-line eligibility, ERA auto cash posting and CSI-Same or Similar checking. Advanced billing edits help insure only clean claims are submitted. The system also bills for retail, wholesale, facilities and Hospices as well as workers compensation claims.
Fastrack allows the user to assign Primary, Secondary, Tertiary or private pay by line item.

Reporting/Executive View: Fastrack offers an Executive Dashboard with key business indicators, a ScoreBoard that provides “real time” updated information on business processes including number of new orders/dollar value entered and processed orders picked/shipped, etc., and a Business Intelligence tool for data mining designed to solve business problems including denials, to analyze how well referral sources are performing and more. Business Intelligence is an easy to use tool that allows the user to pick and choose which fields to show up in a spreadsheet or graphical format. The system comes standard with hundreds of management reports offering numerous sort capabilities. Client can write their own reports with the industry standard Crystal Report Writer.

Customer contact: Fastrack provides the ability to automatically send emails to the patient or facility confirming the order has shipped. We offer integration with Medsage’s IVR system for clinical follow-up with respiratory patients and cpapdropship.com for the fulfillment of CPAP supplies.

Inventory Management: Utilizing wireless technology, warehouse staff can receive orders on their PDAs from the CSRs for fulfillment. Upon picking and scanning the product the system will confirm that the right product was selected to avoid delivery errors. These PDAs can also perform real time receiving, physical inventory and automate the delivery of products offering real time order confirmation from the field. The system supports an unlimited number of branches and warehouses providing the user with the ability to see where inventory of a particular product resides and the option of choosing the appropriate warehouse to ship from. The system also allows for drop shipments from a vendor which is enhanced with our electronic (EDI) purchase orders.

Handheld Devices: Fastrack supports handheld devices for clinicians including Respiratory Therapists to capture clinical data in the field; warehouse and delivery personnel as further described in the Delivery and Inventory Management sections and for sales staff to enter new referrals, orders including establishing schedules for on-going supply deliveries, and to check their accounts via the Fastrack Referral Management Web Portal.

Delivery Management: Fastrack offers the ability to route deliveries to optimize drive time, reduce the operating costs (gas, overtime, etc.) of the vehicles and improve customer satisfaction by providing estimate arrival times at the patient’s home. The system can allocate an unlimited number of orders to the delivery vehicles taking into consideration drive time, weight limitations and required time windows. Using handheld PDAs or Tablet PCs the driver has access to relevant patient information and orders. By scanning bar codes on the products the driver can verify the right product is being delivered and even collect COD amounts including processing credit card payments. The driver can capture the patient’s signature and confirm the order delivery in real time.

Workflow: The Fastrack Automated Workflow Manager tracks every step of a provider’s operational
processes from patient intake and the receipt of a new order (by fax/phone/Internet) to picking the products in the warehouse and routing the delivery trucks. The provider will always know what stage each order is in, if there is any reason it is being held up (i.e. missing CMN/RX, etc.), and who is responsible for the next step in getting it out the door. The Fastrack Task Manager alerts staff to significant events that require action including follow up on new orders.

HDMS

Universal Software Solutions Inc.
www.universalss.com
(810) 653-5000

Years company has been in business: 12
Number of installed systems: 100+
Type of System: a stand-alone system installed on-site, or a hosted, web-based/SAAS system
Software programming languages and database environments used: Microsoft SQL

Features

Audits: The HDMS Compliance module helps you ensure claims are ready to be submitted with a complete history of patient compliance. Payer specific, user defined compliance rules may be defined to accommodate various payers’ rules and guidelines. Coupled with a dynamic document imaging system this module provides all documentation necessary at the touch of a button.

Competitive bidding: Using our reporting foundation the complete database is at your fingertips to evaluate and disseminate data that is important to your decision making process.
Whatever data is entered into the system is available for evaluation in any format you desire either numerically of graphically.

Claims/Billing: The HDMS A/R Manager is a streamlined billing system that helps the user focus on billing exceptions and reduces the time taken to submit clean claims. Also offers  real-time or batch insurance verification process.

Reporting/Executive View: Using the standard reporting tool incorporated into HDMS or the optional Reporting Foundation this solution has the high-level overviews or complete detail needed to run your business in these changing times.

Customer contact: The HDMS system uses integrations with partners such as HealthCall or your own custom solutions to provide access to your customers and referrals.

Inventory Management: A real time inventory system with bar code capabilities for efficient product handling. Tracks serialized and non-serialized inventory for complete asset management.

Handheld Devices: Supports handheld units for warehouse inventory processes and point of sale capability.

Delivery Management: The VendorLink drop ship system offers EDI submission of orders and confirmation of completed orders. Claims are updated automatically for submission. This system drop ships orders without faxes, paper or someone leaving their desk.

Workflow: HDMS allows you to control your activity costs by focusing on a “Customer Service Centered” workflow. An up-front solution focused around your processes increases first-time claim submission and reduces re-work.

Inscrybe Healthcare Referral Management Solution

Authentidate
www.authentidate.com/paperless
(877) 467-2792

Years company has been in business: 20
Number of installed systems: 1,000+ locations
Type of System: A hosted, web-based/SAAS system
Software programming languages and database environments used: .NET/Oracle

Features

Audits: Full audit trails and reporting capabilities including authentication of documents, transactions and timestamps included with audit trails.

Competitive bidding: Smart-forms ensure accuracy and completeness before signature allowed. Streamlined processing of CMNs, Plan of Care, Physician Orders and other referral and order forms.

Claims/Billing: Inscrybe interfaces with most billing and practice management systems, providing streamlined workflow, fax and esign integration. Authentication of documents, transactions and timestamps included with audit trails.

Reporting/Executive View: Dashboard unifies all electronic and fax transactions and provides overview reporting for management to refine and streamline the process of form completion, submission and collection of reimbursement.

Customer contact: Automated alerts on dashboard and via email are offered with flexible settings regarding action items and trigger points.

Inventory Management: Interfaces with most in-house inventory and practice management systems.

Handheld Devices: Web-based solution available with any IE browser.

Delivery Management: Accelerates administrative and clinical documentation necessary to implement medical equipment and services delivery. Interfaces with most practice management systems to transfer information instantly.

Workflow: Inscrybe Referral Management solution is designed to streamline clinical and administrative document workflow. Inscrybe customers report more than 30 percent improvement on average.

MedAct Software

MedAct Software
www.medactsoftware.com
(800) 326-0314

Years company has been in business: 24
Number of installed systems: 600
Type of System: A stand-alone system installed on-site, or a hosted system, using special client software
Software programming languages and database used: MedAct Software Client/Server Edition is a Windows based system utilizing a SQL based RDB.

Features

Audits: MedAct employs an integrated workflow engine that assists providers in submitting clean claims. MedAct employs a variety of tools and checklists during order intake to minimize and eliminate claim rejects and denials, which could trigger audits.

LCDs can be attached to inventory items and to ensure compliance to regulations. File Audit Checklists are used to ensure orders have the proper documentation before claims submission.

MedAct integrates the Compliance Center, which directly targets issues vital to providers facing Audits. The MedAct Compliance Center can generate over 20 pre-payment and post-payment reports. Responding to CERT audits are handled by Review Code tracking and reporting for each invoice and line item. Integrated Document Management utilizing automated bar code recognition ensures all documents are available at a patient, doctor and insurance level for audit review.

Competitive bidding: MedAct Software ships with an integrated Competitive Bidding (CBid) Center where contract and non-contract bid suppliers are able to manage patients, beneficiaries and other contract suppliers in the CMS Competitive Bidding Program. MedAct’s Competitive Bidding Center facilitates the submission of winning CBid contracts by easily managing contract item categories and price levels. MedAct CBid Center includes both round one and round two competitive bid areas (CBA) by zip code for easy referrals. CBid Center makes providers more efficient by easy look ups of procedure codes by contract item categories. Traveling beneficiaries and sub-contractor ordering, billing and deliveries can be handled with ease with MedAct CBid Center.

Claims/Billing: MedAct has integrated billing and authentication tools directly into the software, MedAct provides for realtime eligibility request at the point of patient intake, automated PECOS and NPI registry utilities. MedAct ensures clean claim submission utilizing 37 audits before and during automated claims batch creation. MedAct provides for automated claims submission and remit posting via MedAct Claims Manager and Claims Network.

Reporting/Executive View: MedAct provides a real-time graphical dashboard, with core executive and management data, such as aging detail and aging summary data, sales data, current day delivery and pickup totals, along with claim pending submissions, voided submissions, and denials data measured in dollar amounts. MedAct also functions as a decision support tool as well as forecasting or trending tool. The reports that help manage a DME/HME business include tracking deliveries; denial management; Accounts Receivable; end of month, end of year and quarterly financial reporting; aging and other revenue related reports. Sales reports show which items are selling the most, which salesperson is generating the most sales and the source of the most referrals.

Customer contact: MedAct provides a report area specific to customer demographic and customer contact data, which includes customer contact labels by zip codes, account numbers, and name, which can be exported directly from the software in 15 different ways for email notification and other communication methods. MedAct tracks customer contact and can schedule follow up calls, and the Customer Callback Report provides users a listing of customers needing callbacks for a specific period of time to meet delivery forecasts, customer service and accreditation objectives.

Inventory Management: The MedAct Inventory Management Module provides mobile inventory management tools needed to optimize your capital inventory. The MedAct Inventory Management Module provides mobile and automated capabilities to maintain inventory items, transactions, audit trails, multi-warehouse environments, vendors, lot numbers, and serial numbers. The MedAct Inventory Management Module uses bar code scanning.

Handheld Devices: The MedAct Inventory Management Module incorporates a mobile device for all inventory management aspects. The MedAct Inventory Management Module allows users in the local warehouse or remote field to update on hand counts, receive inventory, send inventory for refills, and receive inventory from refills, all with the automation of barcode and touch screen technology.

Delivery Management: Each handheld device accompanied with the MedAct Inventory Management Module optimizes delivery for all customer orders by creating logistic work orders from data extracted directly from core billing and order information entered by on site customer service and billing staff. Daily delivery confirmations are produced to keep field staff, office staff, and inventory in sync.

Workflow: MedAct uses a workflow of checks and balances to ensure all claims created from the software are sent with confidence and return with payment. MedAct implements the efficient and confident workflow process through creating defaults for inventory items and associating those items with insurances or insurance groups, ensuring steps are not missed in the billing and delivery process. The defaults created for workflow and delivery verifies orders are processed with 100 percent accuracy every time.

MedFORCE Scan, D&R Manager, WorkFLOW

Years company has been in business: not available
Number of installed systems: not availabe
Type of System: A stand-alone system installed on-site, or a hosted, web-based/SAAS system
Software programming languages and database environments used: Software is designed Delphi and uses a SQL database

Features

Audits: The combination of the three products offered: MedFORCE Scan, D&R Manager and WorkFLOW will streamline the efficiencies of your office, centralize storage of all documents and track document printing, plus more.

Competitive bidding: MedFORCE software will help you prepare for Round Two of competitive bidding by providing the tools to allow providers to become more efficient and ease the retrieval of patient files, manage denials as well as manage procedures to reduce errors.

Claims/Billing: D&R Manager is a powerful denial management software tool that allows you to efficiently work claims and denials. Data is available by custom reports and at-a-glance screens.

Reporting/Executive View: D&R Manager uses dashboard and preset reports to provide information on reviewing payment of claims and denials at a quick glance in daily, weekly, monthly or by year. As well as the ability to create reports to run on scheduled for quick access as well.

Customer contact: WorkFLOW provides various escalation events that can trigger reminder emails as necessary when tasks need to be performed or various steps are met.

Inventory Management: N/A

Handheld Devices: N/A

Delivery Management: MedFORCE has partnered with On-Board Communications to provide GPS tracking information directly in a patient file, and with UPS to provide delivery confirmation.

Workflow: MedFORCE WorkFLOW allows the ability to streamline, create accountability and eliminate missed steps and errors with all processes within your operations.

Noble*Direct for Windows

Noble House
www.nobledirect.com
(800) 749-6700

Type of system: A stand-alone system installed on-site
Years company has been in business: 20+
Number of installed systems: 500+
Type of System: N/A
Software programming languages and database environments used: N/A

Features

Audits: Document scanning and image retrieval is included which allows providers to scan and store important documents within each patient’s profile. These include completed AOB forms, doctor’s order forms, CMNs, proof of delivery and others. Many of these required forms are generated and stored within the patient profile automatically. Formal procedures for generation, receipt and storing of required documents allow providers to properly respond to audit requests and avoid costly penalties.

Competitive Bidding: In order for DME providers to bid in Round Two, prior twelve months sales histories must be provided by supply category, HCPCS code and patient both inside and out of the MSA for which the bid is targeted. From the Noble*Direct database, these reports are automatically generated for Round Two. As new patients are entered, that patients’ zip code is checked against current MSA zip codes and warnings are generated for Medicare patients located within an MSA and for which a provider may not have a contract.

Claims/Billing: Noble*Direct, the easiest-to-use and most intuitive billing and claims management system includes all Medicare mandated and enhanced operational features.
Providers can transmit electronically to Medicare, Medicaid and over 2300 private carriers. Instant insurance verification can be processed individually or in batch mode. Included are full document scanning and retrieval, inventory control, pre-defined and custom document creation. In addition, NPI / PECOS registry interfaces, competitive bidding analysis and Quickbooks synchronization are included.

Reporting/Executive View: Variety of sales and A/R reports, historical analysis (Snapshot of Business), payment analysis by payer as well as ODBC-compliant database for third party interface.

Inventory Management: Barcoding of inventory items with scanner integration. Multiple branch and warehouse management for serialized inventory level tracking, on hand and committed stock reporting as well as maintenance control.

Ordering: Formal intake process for data collection, insurance verification and order entry. Order entry includes macro functions for frequently ordered accessory kits. Recurring billing and cap rentals are generated automatically. To assist in reducing denials, edit lists may be requested for claims entered but not yet processed. Claims with incomplete or inconsistent information are identified.

PECOS: Noble*Direct interrogates the PECOS database when new referral partners or transactions are entered. Warning messages appear if referral partners are not registered within the PECOS database.

Delivery Management: Delivery tickets may be generated either for individual patients or for groups of patients (e.g. for those supplies being delivered in the coming week).

Noble*Direct integrates with Google-Maps to provide routing and delivery assistance.

Marketing: Direct interface with Microsoft Word permits all required documentation as well as custom documents and letters to be generated and sent to those patients with email accounts. Flexible patient invoices and statements allow improved communication with patients which includes dunning notification on past due accounts and balances.

Online community: Seamless integration with delivery services (FedEx, UPS, etc.) for proof of delivery management and tracking, electronic integration with “drop ship” distributors and electronic communication with various clearinghouses, payers and other services.

SystemOne

QS/1
www.qs1.com
(800) 231-7776

Years company has been in business: 32
Number of installed systems: 1100
Type of System: A stand-alone system installed on-site, or a hosted, web-based/SAAS system
Software programming languages and database environments used: Proprietary Windows based functionality.

Features

Audits: Detailed documentation tracking and in-depth reporting.

Competitive bidding: Integrated competitive bidding reports provide information
on product and service frequency with revenue dollars generated by those products and services.

Claims/Billing: Real-time patient eligibility checking with same or similar claim status inquiry, electronic billing and payment posting to all four DME MAC’s, most State Medicaid’s and thousands of third party payers.

Reporting/Executive View: Customized reporting tools allow providers to select specific information for management reporting, including claims processing information, denial management and accounts receivable details.

Customer contact: Completely integrated Interactive Voice Response (IVR) that provides automated outbound resupply reminders, inbound resupply requests 24 hours a day, 7 days a week. Automated rental compliance verification and patient satisfaction surveys.

Inventory Management: Inventory management for rental and sale equipment, disposables, supply items and medications. Monitor inventory movement, rental and sale history and on-hand count with integrated barcode technology.

Handheld Devices: Fully functional mobile workstations operating on a ruggedized tablet pc with wireless capability and integrated broadband connectivity.

Delivery Management: System generated delivery manifests provide real-time delivery and pick-up monitoring, driver assignments and delivery information needed for mapping and routing. Customizable tracking status follow equipment from order entry to delivery and are updated real-time with mobile workstations.

Workflow: System integration, process automation and interfaces to document management software, accounts receivables recovery systems and delivery scheduling software contribute to efficient workflows.

TIMS Software

Computers Unlimited
www.cu.net
(406) 255-9500

Years Company has been in business: 33
Number of installed systems: 20,765
Type of System: A stand-alone system installed on-site, or a hosted, web-based/SAAS system
Software programming languages and database environments used: Microsoft .Net and SQL server

Features

Audits: Provides upfront validations needed to minimize denials or take-backs based on insufficient required documentation or lack of medical necessity before equipment is released to the patient. Access any scanned documents through TIMS Imaging such as CMNs, doctor orders, ABNs or clinical notes for example.

Competitive bidding: TIMS offers Microsoft BI reporting tools to analyze profitability by category to help guide you through competitive bidding decisions.

Claims/Billing: Provides automated electronic CMN and authorization processing. Supports secondary and tertiary insurances. Integrates with ZirMed for complete revenue cycle management, including eligibility verification, claims validation, denial management, EOB explanations and ERN automation. 5010 and D.0 compliance certified and in use.

Reporting/Executive View: Includes standard and customizable reports for all business needs, plus ad hoc data analysis with search, filter and sort capabilities. Monitors goal performance, manages workflow or updates customers via scheduled reports automatically emailed to individuals or groups.

Customer contact: Receive email order confirmations for patient or referral sources.

Inventory Management: Supports single and multiple warehouses and bin locations. Bar code tracking for supplies, medical gases and rental equipment, including lot number tracking and recalls. Handles rental equipment tracking and repairs. Offers wireless warehouse management for cycle counting, picking and receiving.

Handheld Devices: Mobile Delivery offers rental verification, auto confirmation of orders, efficient scanning of rentals, ability to capture point of delivery and ability to create orders on the fly.

Delivery Management: Offers built in route optimization. Review and shuffle deliveries between trucks and ship dates. Provides mobile delivery integration for rental equipment setup/pickup, supplies and medical gases. Accommodates real–time on site updates, as well as automated alerts and one click upload and download.

Workflow: TIMS Fusion offers a customizable work flow and priority system. Define the intake process in user-defined stages from first contact through delivery of product. View the current state and ownership pending orders at a glance, and, history of the work flow process complete with dates and times events occurred.

This article originally appeared in the November 2011 issue of HME Business.