At Your Service

• By David Kopf
• Feb 01, 2009

Manufacturers lend a helping hand to providers through enhanced services

Let’s face it; these are not the rosiest of times for the home medical equipment industry. Besides the 9.5 percent cuts to Medicare funding, increasing unemployment figures mean fewer patients with private payor coverage and decreasing consumer spending all translate to tighter margins. Bottom line: HME providers need help.

Fortunately, their suppliers are responding to their distress calls. Manufacturers of all types — large and small, single-product category to multi-line — are offering a variety of no-cost or low-cost services to providers to help give them a leg up in these tough times. The services range from marketing support, to enhanced technical support services, to professional education, to assistance with Medicare claims, and even whole software systems.

If you haven’t already, now is the time to contact every vendor rep you work with and get them to elaborate on all the support services they offer and whether or not they are free or come with a fee, and if so, what that cost is. Furthermore, make sure those reps keep you regularly updated about their enhanced support services, in case any are added or changed.
For now, let’s examine a few manufacturers to see what types of services are available to HME providers to lend them a helping hand.

Invacare iPartner Solutions

One of the most instantly recognizable set of enhanced provider services is Invacare Corp.’s iPartner Solutions, a suite of programs that debuted last year.
“We have three families of services that we offer as part of iPartner solutions: equipment maintenance solutions, business solutions and billing and collections solutions,” says Chris Yessayan, vice president and general manager, Invacare iPartner Solutions. “Within each one of those we have various things we offer.”
For example, on the equipment maintenance side of things, iPartner solutions offers a 5 Star service plan, which provides labor support during warranty for

Invacare chairs, and offers post-warranty repairs of any and all consumer power wheelchairs in a patients home using its Roadrunner organization (Invacare acquired Roadrunner Mobility, approximately a year ago). It sells parts through its service parts business, as well as parts for even competitor products, to give providers a partner that is a single parts source.
Likewise, iPartner’s repair services for items such as portable oxygen concentrators not only services Invacare equipment, but competitor products, as well, Yessayan says.


“What we’re trying to do is make sure that when we offer services, that they’re not just specific to Invacare products, because most providers buy multiple OEMs’ products,” he explains. “So if we want to offer providers a solution, then it really has to be geared toward solving all of their problems in terms of maintenance, or all their problems in terms of billing, or all their problems in terms of taking costs out of their business.”
Beyond product support, iPartner also includes HCS, which resulted from Invacare’s purchase of Bargmann Management LLC. Invacare HCS focuses primarily on collecting patient co-pays. Patient co-pays represent a tough challenge for providers because they take time to collect.
“Patient co-pays are difficult, at best, to collect today, Yessayan says. “And let’s face it, with the changes in the economy that have occurred in the last three or four months, they just got more difficult to collect.”
iPartner also runs a Sleep Success service for providers that run large CPAP businesses. Those providers must replace masks and tubing and filters on a scheduled basis and HCS will call patients on behalf of the provider to determine if they need replacements, and if so work with the provider to ensure the order is filled and the patient is served.

Another iPartner offering is the Bonafide Management System. Through a partnership with Bonafide, Invacare offers Bonafide’s web-based system for managing provider businesses. Using a standard computer with an Internet connection and Web browser, providers can use the HME-specific system to manage various aspects of their provider business, such as billing; filing claims with Medicare and other payors; inventory management; customer service; and data entry/management.

“We recognized that ease of access to data and reporting and streamlining your organization through access to information would be something that would benefit business,” Yessayan explains.

Invacare iPartner’s training organization also provides education to its providers in the form of training sessions to show them how to repair various pieces of equipment. It also has hosted best practice sharing events at various provider summits. It also provides accreditation consulting via HME Advantage.
Each iPartner service includes a fee service that depends on the type of service being used. So, for instance, if a provider uses the patient co-pay service, it would pay based on a percentage of the co-pays collected. The Sleep Success business charges fees based on the patients visited. For the 5 Star labor coverage, that is $150 per chair. The Bona Fide service is a monthly fee based on the number of users as well.

At the end of the day, all these services come down to ensuring that Invacare’s provider customer base remains stable and grows; a natural, win-win, Yessayan says.
“We’re trying to be an extension of the provider’s organization, because we’re successful in what we do, then we help our providers be successful in their operation,” he explains. “With that 9.5 percent cut and that 36-month cap ... that is a big chunk of revenue and ultimately profit you just had taken out of your business. ... So we are trying to find another way to be a value to our providers.”

Pride Mobility

Another large manufacturer that offers a variety of enhanced services to providers is Pride Mobility Corp. Like Invacare, Pride’s goal is to be a partner with its providers, and has been offering various enhanced services for several years.

“We offer a breadth of services designed to grow our providers’ business,” says Tiffany Cloud, Vice President of Customer Support & Fulfillment. “Those capabilities range from marketing support services, to reimbursement, to technical support services and education.”

Many the enhanced services Pride offers providers come at no charge, or competitive rates, she adds. To help providers get a full view of its enhanced support offerings, Pride offers PrideProvider.com, which lets providers of Pride products log on to get information on Pride products and services.

In terms of marketing support, Pride offers complete marketing consultation services, which includes marketing and advertising information, as well as suggestions and advice on how to create a complete marketing campaign based on the provider’s business model. The consultations are free, and conducted on a regular basis, Cloud says.
“We also offer merchandising support, guidance on how to effectively merchandize retail showrooms and we will work with providers to supply merchandising materials,” Cloud explains. That includes banners and hang-tags, as well as other forms of merchandising support.

Additionally, Pride offers design services for ad slicks, posters and other advertising materials, and even offers video editing capabilities and a photo studio to help providers develop video, print and radio campaigns, she adds. It also offers web development services to help build provider sites. Some of the advertising services are free of charge, whereas others are offered on a fee basis, but at a fraction of the price of an ad agency.

Cloud says an increasingly important element of Pride’s enhanced services are its educational offerings. Education is in demand from providers because of the number of hours in continuing education course provider staff must attend in order to maintain their certifications or licenses in their respective states. To respond to that Pride offers a seminar tour throughout the year at various cities, offering seminars on technical training, reimbursement training, advanced seating and positioning, and retail sales. Pride’s education department works with providers to develops the courses based on their needs, and has had thousand of them attend the course, Cloud says.

“The nice thing is that providers can pick and chose the courses they want to attend, based on what their needs are,” she says.
And the demand is there for these services. Cloud says Pride has seen a recent uptick in demand for its enhanced services. “Everybody can appreciate and looks for business partners, and particularly in times that are fraught with more challenges, providers want to be as smart as they can be to work in the existing and anticipated [business] environment and getting the perspective of their manufacturing partners is something that I think is beneficial.”
Cloud says Prides reimbursement department is a good example of that exchange. “We have a lot of people in our Reimbursement Department who came from

Medicare, so maybe if a provider is having problems with documentation, we can work with them on pre-screens of documentation, or coding analysis or appeal and recovery assistance,” she explains. “We can do a lot for them and any opportunity to for us to work with our providers is exciting for us to do that.”

Aetrex Worldwide

Another manufacturer that puts a high value on education is Aetrex Worldwide, which provides various orthopedic footwear offerings. “A big part of what we’re about is education,” says Matt Schwartz, vice president of sales for Aetrex.
Aetrex focuses on service with a 43-person sales team that includes eight tech reps whose sole job is to focus on educating clients. “Their entire job is to go into stores and tell people about our products,” Schwartz says. “We have more than 25 certified pedorthists of those 43 people.”

Also have a staffer dedicated to webinars. Every day of the week, providers can log on to access live session and training on the company’s products and technology. Another person on the sales team is designated at the director of pedorthics, and that person hosts various classes on the subject.
“We’re doing approximately 30 courses next year,” Schwartz says. “We do an ABC Shoefitters course and we do the BOC [Board for Orthotist/Prosthetist Certification] course, as well, to provide the relevant certification to facilities so that they can provide better care for patients with diabetes.”

A centerpiece of Aetrex’s business is a technology called iStep, which involves a flat platform that patients step onto. The system then analyzes their feet to determine the appropriate products for that person’s needs. It measures to the tenth of a millimeter and provides data on all the pressure points and arch type to increase the footwear’s customization. “You can build custom orthotics with it, and order heat-moldable inserts from the kiosk,” Schwartz says.

Aetrex created special software system called iStep Evolution Rx that then helps the provider order the correct products. The system will tell the provider which shoes are SADMERC verified to ensure the footwear is covered. The shoes and other items can be ordered and then shipped to their store. This not only helps the provider make the right choice, but also means the provider does not have to stock a large array of inventory, thus reducing overhead costs.

And, to help patients, Aetrex also created foot.com an in-depth online information source for foot healthcare information. Visitors to the site can post questions to a podiatrist and get information on everything from diabetic to athletic foot care information. Better yet, a lot of this information is also available on the iStep system, giving providers a solid customer service and education tool that speeds up the customer service process so that provider can move on to the next patient.

“Let’s say a patient has Achilles tendonitis, they can actually bring that up on screen and show them that information and print it out and tech them about the condition,” Schwartz says. “It’s a powerful tool if you have a serious referral business and want to elevate the level of service within the facility.”
To further streamline the process, Aetrex also an option for iStep that includes a rack with a fitting inventory of shoes so that they patient can then try on various examples of the footwear the system is advising. That offering requires a $250 per-month fee and a one-year commitment.

In terms of marketing support, Aetrex employs more than 10 people in its marketing department that develops lots of in-store support via signage and brochures and similar materials, but it also provides co-op marketing services to its provider customers, which can be customized. Under the program, a percentage of the ad is covered by Aetrex, and a percentage of the ad is covered by the HME based on their sales.
“We’ve done radio, and a lot of print, but it’s really up to the facility,” Schwartz says. “For instance if a facility was invested in the program and said, ‘Hey we want to get the word out about what we’re doing, and we want to run a radio ad,’ then we would co-op that radio ad with them, and help them with the contact. It’s really up to them.”

Juzo USA

Another category-specific manufacturer with a progressive attitude toward enhanced provider resources is compression garment maker Juzo USA. Juzo offers a Dealer Toolbox website at juzousa.com/dealers that provides a variety of no-charge tools for ordering and information, as well as e-learning offerings. For Juzo, the web is the key.

“We’re trying to provide a lot more resources online for providers so they can get tools at the click of a button,” says Tom Musone, marketing director for Juzo.

The Juzo Dealer Toolbox includes time-savers such as online ordering, online forms for facilitating returns, or custom orders, as well as turn-key marketing materials providers might need. A highlight of the Toolbox is a set of e-learning offerings Juzo has just begun building out.
“As more people are getting into the compression market due to the fact that they are looking to increase cash sales due to factors such as competitive bidding. So people are looking for training and education.

While Juzo would always recommend a sales rep should go in for an in-service to train staff, Musone says there are many instances where a provider might forget to train a certain employee or wants to get someone up to speed sooner rather than later. So it developed Juzo E-learning.
“One of the big things is measuring; people forget the proper way to measure,” Musone says. “There’s a good correlation between a good fit and keeping the patient happy, and ultimately, that’s what the provider wants. The more you can understand and be trained properly, then the better off you’ll be in terms of retention and acquisition.”

So, Juzo put a series of videos online to help ensure dealers understand the proper way to fit compression stockings and hose. These videos are supported by other tools such as downloadable sizing charts. Future e-learning videos Juzo has planned include installments on marketing compression garments and updates on conditions such as deep vein thrombosis, he adds.

Whether its marketing support, education services, or other enhanced support options, Musone says he expects there will be increasing demand for these sorts of offerings over the short-term.

“These value added programs are necessary, because we’re getting a lot more HME supply stores that need these tools to start a retail compression business,” he says. “As they expand their product mix they’re looking for tools that can help support that product mix and I think that’s where a manufacturer is smart in helping them do that.”

Points to Take Away

•    A tightening funding environment and economic pressures are forcing providers to look for new ways to cut costs and drive new revenues.
•    To help their providers, a variety of OEMs are offering enhanced support services.
•    These services range from tech support, funding support and services, marketing services, consulting and even HME provider software.
•    Depending on the offering, these services are sometimes no charge, or very competitively priced in comparison to standalone commercial offerings.
•    Reach out to your manufacturer reps to ensure they are updating you on all their support offerings.

Learn more

Here are some examples of enhanced provider support offerings worth examining:
•    Invacare iPartner Solutions — Invacare has grown its enhanced provider resources both organically and through acquisitions and partnerships with third parties. Learn more at Invacare.com.
•    Pride Mobility Corp. — Pride has been growing a range of support services for several years now, and the result includes beefed out marketing support, technical services and professional educations. Visit pridemobility.com.
•    Aetrex Worldwide — Footcare manufacturer Aetrex emphasizes professional education by not only offering various courses, but ensuring the majority of its sales staff are certified pedorthists. It also offers a unique platform for helping providers more efficiently assess footcare needs. Visit aetrex.com.
•    Juzo USA — Compression garment maker Juzo offers various dealer services and tools via an online dealer toolbox. Check out juzousa.com/dealer to see its Internet based support and information tools, as well as e-learning offerings.

This article originally appeared in the February 2009 issue of HME Business.