How to Use Software to Identify and Track Performance Metric

HME providers know they need to track data and metrics to improve their business and operations strategies, but what does that actually mean in practice?

• By Haley Samsel
• Jul 07, 2020

METRICS WORTH TRACKING

There are a few staple metrics that HME providers should be paying attention to at all times if they hope to maintain their bottom lines and eventually improve them. Number one among those performance indicators are medical documentation metrics.

Documentation remains the slowest and most difficult part of any HME provider’s business, making it crucial for them to track how long it takes to acquire valid medical documentation. In addition, providers should take a hard look at how much of the documentation they acquire is not valid and how they are storing this data so that it can be easily recalled for an audit. Several software solutions in the industry, including those offered by Computers Unlimited and Universal Software Solutions, are specifically designed for HME providers to track documentation – the linchpin of their business.

In addition, another must-have metric is claims denials, which should be approached from two different angles. A claim that denies one time, or a first pass, can show a provider nearly all of the issues they are having on the front end of their business.

Process breakdowns become doubly obvious if the claim is denied a second time, allowing management to see what is going wrong with billing staff and A/R collection teams in terms of common errors. From there, providers can decide how to remedy the situation through increased training for staff who handle claims or more oversight of the entire process.

Other metrics that deserve providers’ attention include order/sales volume, held revenue by average daily sales on hold, held revenue by volume, claim submit volume and cash collection. These metrics are often developed into reports, formatted in the form of a “check-up” or “report card,” that can be shared with referral sources, vendors and even patients themselves.

As software develops further, more HME professionals are relying on real-time dashboards that create custom reports without having the data bottlenecked by one or two employees, making it more accessible to staff members dealing with claims or other crucial parts of the business.

CHARTING YOUR SOFTWARE PATH

Providers are all over the map when it comes to software familiarity and implementation. While some are up to their elbows in data metrics that they can use to improve business practices and market themselves to referrals, others are still fresh to the possibilities of metrics reports and data analysis.

The path of least resistance is getting started with the software solution’s standard reporting feature. Most solutions have configurations and criteria that can display reports in either detailed or summary formats. CU’s TIMS Software provides reporting data that can be exportable to spreadsheet format, with the option to use other business intelligence tools like MS Power BI.

If providers need a concrete example of how software can solve a business process issue, look no further than a claim denial called CO-16. The issue, commonly addressed by Universal, involves a claim that lacks information about what needs to be paid. A provider may look at any 30 claims that received the same rejection from the same payer, but the provider may have taken 30 different actions to resolve each case.

The only way to identify trends in case resolution is through taking advantage of the data that has already been collected – and by creating smarter processes or service choices to prevent that claims denial from happening in the first place. These are the types of “gold mine” moment that software solutions make possible.

RESPECTING PATIENT PRIVACY

Providers may worry that sharing reports or other meaningful feedback externally could put their patients in jeopardy. But HME businesses can easily respect patient privacy while still connecting with referral sources and finding ways to greatly improve business processes. When tracking medical documentation, providers are looking to answer the question: Who are the doctors who are slower in returning information? Are we not getting them what they need in order to respond faster? Office managers and HME sales representatives will have an easier time resolving these issues if they have hard numbers of how long it takes for a prescription to get returned, even if it’s only broad statistics that do not identify patients.

These are just a few of the ways that software solutions and their data analysis capabilities can make a difference in providers’ businesses. Each software solution is different, but all vendors share a common trait of seeking creative ways to process and share data across the homecare continuum, whether it’s providers, referral sources, manufacturers or patients.