Industry Update

NAVIGATING THE MINE FIELDS - BEFORE IT'S TOO LATE!
A 'Must-Read' article for ALL Sweet-Billing Customers
by Steve Johnson, Director of Sweet-Billing Services

One of the most unfortunate situations we see customers find themselves in, is summed up in the statement, “The only person that really understood the details of how our system is set up doesn’t work here anymore.” Probably, the second most unfortunate statement is, “I had no idea the system could do that!”

Either of these can have a huge impact on your financial bottom line! In these days of increasing squeeze on reimbursement levels, it is imperative that we know for sure that we are billing the correct Payor, in the correct way, as soon as humanly possible - and that we are doing that as efficiently as possible. While we may not have much control over the amount several Payors will pay us, we do - to a great extent - have control over how long it will take to get that money (days in A/R) and how much time and human energy (money) we will spend in our efforts to collect it.

A couple of examples of statements we have heard that point to possible inefficiencies and increased costs of operations (if not clear and present danger) include:

“We had onsite training when we first implemented the program. Things can’t have changed that much since then.” First of all, nothing in this industry stays static for very long. It is very likely that since your original installation, your needs have changed. In just the last few years, there have been industry changes on a grand scale - for example: HIPAA, an Ambulance Fee Schedule (with several modifications to it), Condition Codes, NEMSIS and new requirements for State Data reporting, just to name a few. In addition, you may have had some unique changes in your organization such as new contracts, new requirements for specific Payors, or transitioning from the old “Method 4” billing to all inclusive Base Rates. Any of these things could mean necessary changes to your system setup, in order to run as efficiently as possible. Secondly, during the initial training, all of your staff was seeing a new application for the first time. It is difficult to absorb all that is presented in a few short days, when discussing an application that you are not at all familiar with yet. Even if all possible scenarios were discussed (which is doubtful), it is impossible to expect that everything covered was remembered completely.

“We’re pretty sure there is something wrong somewhere, but have no idea how to figure out what it is.” This statement most commonly follows, “The only individual(s) that really knew the program inside out, and always took care of the system setup and maintenance, no longer work(s) here.” Unfortunately, when it seems too late is usually when we all come to understand the importance of cross training and good documentation of system setup and processes. The importance of this multiplies exponentially in a complex setup such as a Billing Service with multiple Directories; however the importance of cross training and good documentation of system setup and processes is very real, and absolutely critical for any system. While this is certainly a very scary place to be, it is neither the time to stick your head in the sand, nor to just throw up your hands in defeat! We have successfully helped customers in that very situation turn things around, and regain control of their system. The important thing was that they were honest enough with themselves, and with us, to communicate the truth that most want to deny.

We offer several different formats of recurrent training, each with different strengths for different scenarios and different relative costs.

1. Recorded classes are a great benefit of your Support Contract! These offer the opportunity for you and your staff to learn about, or review, a specific area of the software on your own schedule, and at your own pace.
2. Webinars are frequently offered on industry “hot topics,” as well as software enhancements. These often free, or low cost presentations, are a very cost effective way of keeping everyone in your organization updated on changes in the industry, as well as coming changes in our software applications.
3. User Groups are offered in varying locations throughout each year. These offer the opportunity to brush up on core functionality of the program, as well as to learn about new tools that are available to help make your system more efficient. They are also a wonderful opportunity to network with other industry experts, your peers, and discuss issues of common concern to all of us, and to share solutions that have been developed and implemented to address those problems.
4. On Site Training/Consulting is also available, and is most effective in those circumstances where everyone is just feeling lost and “in trouble,” and you really feel the need for both a “fresh start” and a better understanding of several areas of the system. It is also the best if your desire is to have someone “just look at how we do things here, and offer suggestions for process improvement for greater efficiencies.”

Whatever your individual needs are, and whichever of these options seem best to you, know that our goal here at Ortivus is to assist you in being as successful as you can be! Everything that we do here, including operating our own in-house EMS Billing Service, is done to gain the first-hand industry experience and insights necessary to help our customers operate with the greatest efficiency, and best results possible. Please don’t hesitate to avail yourself of these valuable resources. Those who have, tell us that it pays for itself many times over!