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How to marry reimbursement with cash sales is a must in today's environment. Allowing patient choice with a properly executed ABN enhances the patient's knowledge of your business and potentially builds revenue. Diversifying your book of business will keep you healthier to weather shrinking profit margins.
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(c) Lieber/Weil2008
Compliance, Cash and Compliance, Cash and Reimbursement – Yes, Reimbursement – Yes,
You Can Have All Three You Can Have All Three
Miriam Lieberand
Colette Weil
(c) Lieber/Weil2010
Seminar ObjectivesSeminar Objectives
Examine opportunities in operations and marketing to build cash sales
Discuss cash sales situation with reimbursables– Ex. wheelchair, oxygen and bed
Review how to selectively use ABN Explore how to build cash sales mentality into
your operations and marketing efforts
(c) Lieber/Weil2010
Current MarketplaceCurrent Marketplace
Operations Audit frenzy Compliance focus Competitive bidding
uncertainty Convoluted third party
payer contracting – Smaller coverage
percentages– More patient out of
Marketing Patient/consumer/
referral source information paucity
Clarity in service/products offered
Revenue diversification Media changes Data analysis for
revenue enhancement Strength of relationships Where to invest
(c) Lieber/Weil2010
Patient (Consumer) Patient (Consumer) ExpectationExpectation Who defines patient expectation– Third party payer– Competitors– Media– You
Patient vs. consumer view– Patient managed, consumer responsible
Other healthcare providers approach– Cash up front– Participating provider– Service primarily– Do not sell other items outside of service necessarily (soft sell)
(c) Lieber/Weil2010
Getting from Patient to Getting from Patient to Consumer Consumer What do other healthcare services do? – Ask for the money upfront– Contact info, email info, complete post card for notification of
service or event
Approach as consumer and from your consumer’s viewpoint– Choice– Referral driven or recommendation– Services provided– Education on what is paid for– What other consumers purchase with primary item
• Why, how, when– Selection, price, service mix
(c) Lieber/Weil2010
Referral ExpectationReferral Expectation
Satisfy patient No complaint calls to office Unaware of products/services to help patient– Time/care/interest?
Little time to spend on your issues– Just wants patient taken care of
Doesn’t want to be second guessed Doesn’t want to owe you anything!
(c) Lieber/Weil2010
Educating Referral in Educating Referral in Consumer ChangesConsumer Changes Presentation is key!– New products, new hope – cash expected
Explain changing regulations Fewer dollars available from third party payers Increase in consumer’s financial responsibility – Equates to increase in consumer’s desire for
knowledge Redirect consumer into understanding their needs
can be met if they are willing to pay– Asking for the money up front is an absolute
necessity!
(c) Lieber/Weil2010
Up Front Insurance Up Front Insurance Gathering = Educated Gathering = Educated Intake Intake Must verify insurance up front Solidify payment arrangements before rendering
service– Even if patient has to wait
Make educated decision about what to provide patient
Obtain medical necessity documentation at intake
– Ensure payment – Time to retrain staff and referral community
• After all, other health care providers simply expect the cash!
(c) Lieber/Weil2010
Asking for the Money Is Asking for the Money Is Not TabooNot Taboo What’s good for the doctors is good for HME Expect cash Employ professional, matter-of-fact style Once you know how much to expect, you know how
much to collect up front If patient doesn’t pay, why render additional
supplies?– Must check outstanding balance when patient calls
for supply refill If you don’t ask, you definitely won’t get!– Human nature
(c) Lieber/Weil2010
Legal Guidelines: Marketing to Beneficiaries (“Benes”) – What You Can Do May contact by telephone and email if
one of the following exists:–Beneficiary has given written
permission–Supplier previously provided covered
item to beneficiary and supplier is contacting regarding covered item–Supplier has furnished one covered
item in past 15 months
(c) Lieber/Weil2010
Current Customers are Best Source for More Business
Current referral sources change jobs and will continue to refer
Current customers refer – after 10 purchases, that customer has referred 7 customers to you
Regular customers are worth five to six times more than anyone else
Increasing a customer retention rate by only 5% can boost the average customer net present value by an astonishing 35% to 95% (Source: Bain & Company: Microsoft Business for Small
and Mid-Size Companies)
(c) Lieber/Weil2010
(c) Lieber/Weil2010
Customer Service Easy Customer Service Easy Follow-UpFollow-Up Gathering email at intake is critical Follow-up timing Personal letter, phone call, versus email– Age dependent
Complete post card for next notification Make sure you know where to find
customer/caregiver – Next of kin – cell phone, email, text
Reiterate promise/plan– Follow-through is key!
(c) Lieber/Weil2010
How to Ask/Presentation How to Ask/Presentation is Key is Key
CSR– Start with one primary Medicare item– Phone script
• See Tammy Zelenko’s Seminar (Increasing Cash Flow through Cash Sales)
• Prepared follow-up method –Letter/email/postcard
Retail sales person– Merchandise for easy demonstration– Show items for need
• Testimonials
Set incentive– Monitor for one month - Track sales
(c) Lieber/Weil2010
Cash Sales and Cash Sales and ReimbursablesReimbursables Hospital Beds– Sheets– Pillow– Sheet lifter– Egg Crate Cushion– Bed tray/caddy– Over the bed table– Urinal– Reacher– Briefs
Consumer approaches– Checklist (BB&B)– Testimonials and
examples– Stories– Visuals– Staff picks
(c) Lieber/Weil2010
(c) Lieber/Weil2010
Cash Sales and Cash Sales and ReimbursablesReimbursables Wheelchair–Gel or Foam cushion– Tray– Underneath Pack– Transfer board– Ramp – Bath items
(c) Lieber/Weil2010
Cash Sales and Cash Sales and ReimbursablesReimbursables Oxygen – Over the bed table– Footrest– Bed pillows– Pedlar
(c) Lieber/Weil2010
(c) Lieber/Weil2010
(c) Lieber/Weil2010
General Cash and General Cash and reimbursable itemsreimbursable items Walker– Pouch/utility– Specialized tips– Basket/pouch– Tray
Commode Shower chair– Floor mat– Hand held shower–Grab bar– Back scrubber
(c) Lieber/Weil2010
Diabetic Supply Add-on Diabetic Supply Add-on SalesSales
Item HCPCS Care Reimb. Cost Care Allow. MSRP
Home blood glucose monitor E0607 Y 70.16*
Test strips (50/box) A4253 Y 38.79* 33.43* KL
Lancets (100 ct) A4259 Y 12.66*
Heel/elbow protector N
Pedlar Exerciser N
Sugar free candy - assorted fruits N
Diabetic Lotion - 6 oz. N
Diabetic sock overcalf (size S,M,L) N
*Ceiling allowable
(c) Lieber/Weil2010
Medicare Compliant Consumer It’s OK to have Medicare consumer buy non-
covered product If patient wants a Medicare covered item but
does not want Medicare billed, use ABN and option 2
Some are willing to pay after they are informed of Medicare guidelines– Transport chair example
(c) Lieber/Weil2010
How to Selectively Use How to Selectively Use ABNABN Patient choice Your protection Do not coerce Explain carefully No “blanket” or “generic” ABN but specific use
with legitimate payment doubt is acceptable Form is often completed incorrectly– Use valid reason – script ok – preprinted reason
ok– Audit for validity
(c) Lieber/Weil2010
Existing Patient ValueExisting Patient Value
Patient’s primary reimbursables New emphasis on total patient with consumer
needs over time/life Additional patient/family purchases– Tracking cash purchases by customer #– Sample of 10 patients, no CSR
• 10 patients with CSR contact
Frequency of contact Average length of relationship Impact on cost analysis of grandfathering
(c) Lieber/Weil2010
Marketing for Maximum Marketing for Maximum Return Return
Demographics and media matter Promotional incentive guidelines for
prospective and current Medicare patients, $10 retail per item, $50 retail max per year
Sales on cash items, bundling, free with purchase
Manufacturer donated items Valuable content to help in decision-making
(c) Lieber/Weil2010
What’s Your Plan?What’s Your Plan?
Primary items/needs to tackle Assess target customers in database Determine what is the best method of contact for your
audience Lay out script Materials to be used Practice Incentive Test Measure Let it roll and count cash
(c) Lieber/Weil2010
Speaker InformationSpeaker Information
Miriam LieberPresident: Lieber Consulting15030 Ventura Boulevard, #786Sherman Oaks, California 91403818-789-0670818-990-9466 (fax)Email: [email protected]: Lieberconsulting.comFacebook: miriamlieberconsulting
(c) Lieber/Weil2010
Speaker InformationSpeaker Information
Colette WeilManaging Director: Summit Marketing3 Marsh Drive, Mill Valley, CA 94941415-388-5303415-388-2675 (fax)Email: [email protected]: summitmktg.com