Despite the difficulty of selecting and fine-tuning the right applications,
an integrated suite of software applications, whether run in-house or
externally by an outsourcer, is essential for every HME.
Research and shopping are the most difficult parts of the software-selection
process. It’s tedious because comparing one system with another is rarely
straightforward. Vendors configure their software differently, even though they
all attempt to automate the same processes. To avoid being overwhelmed by
everything on offer, all of it promoted as best-in-class and unrivaled, you
need a method. So, here?s some guidance from independent experts on researching
your various software options.
Here are the essential questions to ask your vendors. If possible, get them
to actually show you how their system works with regard to each feature or
functionality you?re interested in.
1. What are the elements of your solution? Every solution will have certain
common components, like claims management and inventory tracking. The key here
is to look for functionality that tracks with your conception of how your
business should run. Maybe you like to set up patient follow-up appointments
yourself because it adds a personal touch. So, perhaps you don?t need an
automated scheduling system that automatically generates appointment notices.
2. How well are the elements of your solution integrated? This is perhaps
the most important criterion. From patient intake to the applications that
schedule deliveries and route delivery-trucks, all the applications should
effortlessly communicate. Ask to this capability in action, preferably at an
existing customer’s location. Make sure you can clearly see how information and
work products flow from one application to another.
3. How much flexibility does the solution allow in areas that are especially
important to you? For example, perhaps you have a fairly even mix of Medicare
and non-Medicare payers. Does the claims-management system allow for statements
and claims to be directed to multiple insurance plans? Can you store Medicare
and other forms in the system and easily populate them with patient information
and, then, either print them or electronically submit them to a payer, patient,
4.Are the applications user-friendly? Do they invite engagement, or are they
off-putting because too cluttered, intimidating, or confusingly organized? Do
they seem complex and hard to understand or transparent and intuitive? Will
your staff be able to learn them fast? Ideally, applications should combine
simplicity and the power to get the work done.
5. Do the applications, particularly those dealing with inventory,
accounting and finance, and documentation, satisfy and support CMS?
accreditation requirements? Do they have the financial analytical power to
support you in preparing Medicare bids?
6. Do the applications support these functionalities: CMN tracking, claims
processing, automated claim generation, scheduled billing, on-demand
explanation of benefits, rejection/denial management, and secondary-insurance
7. What are the most innovative aspects of the applications? For example,
some applications detect errors in claims and orders, making it difficult to
submit documents that will be rejected or returned. Others keep track of
expiring authorizations, preventing costly billing-cycle disruptions.
8. Take a close look at billing systems. Be sure to clearly understand how
good they are at getting bills out quickly and accurately? Do they provide
automatic recurring billing?
9. How comprehensively does the solution automate the reimbursement process?
10. Does the solution automatically accommodate Medicare and
11. Does the solution’s Inventory system measure up? Inventory components
range from mere spreadsheets to integrated barcode technology that provides
real-time inventory data, identifies products that have been recalled or
superseded, and enables rapid ordering and fulfillment.
12. Do the solution’s reports give you a comprehensive picture of your
business rather than discrete reports that make it difficult to turn data into
knowledge for decision making?
13. Does the solution provide a comprehensive scheduling function? Some
track and remind you of equipment-maintenance schedules, patient follow-ups,
and service calls. Do you need this capability?