Rick Graver on How Medtech Services Has Met Client Needs for 20 Years
In this current age of accreditation, quality standards and funding wars, what does it take to succeed in service?
Medtech Services in Reno, Nevada, boasts a 5,000 square-foot service department, plus 2,000 additional square feet of service-related storage space. Owner Rick Graver, CRTS, estimates that one-third of Medtech’s business — sales, service, etc. — is Medicare related. Says Graver, “Service has been the heart of our business for 20 years. Our business was started on wheelchair repair.” So we asked him for a profile of his service department and what everyday procedures lead to Medtech’s success.
Mobility Management: Has the way you run your service department changed a lot since 1988, when Medtech Services opened its doors?
Rick Graver: Yes, most definitely. We didn’t even have computers when we started our service department. Way back then, it was a manual system. Now you have to follow all the guidelines. We use the computer every day; it’s used a lot. But the way the service is provided hasn’t really changed.
MM: Walk us through the service process at Medtech.
RG: It starts when the phone rings. There’s somebody on the phone who has a service-related question. We need to determine, number one, if they’re a customer of ours, if the equipment is something that they got from us. And if it’s something that they got from us, we have to determine the funding source. If it was a piece of equipment that was provided through Medicare by us and we qualify that they haven’t gotten something else, that the Medicare guidelines are going to be followed in terms of repair, we’re going to proceed to repairing that piece of equipment for them because it’s owned by them. That’s probably the most key component to service: Making sure that you’re servicing the right piece of equipment.
MM: So intake is crucial?
RG: Absolutely. If it’s our customer, it’s easier because we can identify the equipment based on what was paid for. The chair has serial numbers, so we’re going to be sure we’re identifying the chair by serial number so that we’re not working on something that wasn’t paid for or that we’re not working on something that isn’t going to be reimbursed.
MM: So that’s the first thing your intake department tries to figure out: What needs to be repaired and where the funding is going to come from?
RG: Yes. If the customer got that piece of equipment on the Internet or they bought it off the TV, and we don’t know who they are, we’ve never done business with them before — if they’re requesting that we submit a claim to their insurance, we have to go through the entire intake process to determine what they got, where it came from, was it paid for, and have they had anything else (similar equipment under funding guidelines). Again, you don’t want to be servicing the wrong piece of equipment.
In many cases, that’s really hard to determine. We’ve had cases where people have come to us and said, “I got this chair from ABC Company in California, and they submitted a claim to Medicare, but Medicare never paid for it, and the company went out of business” — which goes hand in hand, because if Medicare’s not paying their claims, they’re not going to be in business very long. Now the customer’s got this piece of equipment that, in their mind, they own: The company’s gone out of business, and no one’s asked for it back, so it’s theirs. But Medicare never paid for it. There’s going to be an issue with funding, because if Medicare never paid for that equipment, it may have been denied for medical necessity. And the repairs wouldn’t be covered, either.
MM: So what do you do in that case? Do you take the case and take on all the funding research that goes with it?
RG: We’ve got to follow the guidelines. If we need to advise the patient in writing that the repairs may not be covered, we’re going to do that. And we may have the option of billing the claim non-assigned.
MM: Let’s talk about your service department. How many full-time employees do you have working there?
RG: Three technicians. Customer service handles everything; there is no one person dedicated to (the service department) in customer service. Five more people drive around and make repairs in the field. All the salespeople also know how to make repairs. The delivery people are factory trained as well. When they’re making deliveries or setting up a hospital bed, they may very frequently get calls to install batteries in the field. We try to do as much service work as we can out in the field. The delivery people can fix upholstery, do troubleshooting, see if the chair’s been turned off accidentally or is in freewheel… there’s a lot of reasons the chair won’t run, but that the customer may not recognize or know. We don’t get paid for those, but we do it as a courtesy.
If it’s going to be a complicated repair, where the person has to be out of the chair and the chair has to come in, then the driver’s out there bringing the chair in, then bringing it back.
MM: What are the top challenges of running a service department?
RG: One is parts inventory. There are a number of different types of joysticks and controllers and electronic components you want to keep on hand. If someone’s power chair goes down and it’s a joystick or a controller or something electronic (that is malfunctioning), you want them to be up and running as soon as possible. If we have parts in stock to sell them or, more likely, we’ve got them in stock to loan them — then I’ll loan them one of the joysticks we have here while their joystick is being replaced or repaired. That’s an option. You don’t want them to be down if you have a joystick to loan them.
MM: But you can’t possibly always carry every different joystick in stock.
RG: We try to have all of the different models of joysticks and controllers in stock, and sometimes that is a challenge. Tires are the other one that’s a challenge — making sure we have the right sizes in stock. There are a lot of high-pressure tires that have similar sizes, but they’re not the same. When we order, we think we’re ordering the proper tire, but we could end up with the wrong tread pattern. And that rubber is expensive. I don’t know what the answer is to that, except that you have to know what you’re looking for.
That’s a problem with service: determining and stocking the right parts. If the customer wants blue Naugahyde upholstery, and you come out with baby blue Naugahyde upholstery, and they say they wanted dark blue or medium blue or royal blue… There are so many different colors.
We won’t sell anything we can’t service. If a manufacturer comes to me and says, “We want you to carry our line,” the first thing I ask is “What is parts availability and service?” Because I’m not going to sell something that I can’t get parts for. The availability of parts and service drives our purchasing decision. So does technical service from the manufacturer: If they don’t have someone we can call when we have to troubleshoot something, we’re not going to buy from them.
MM: Do you have standard parts that always stay in your delivery trucks?
RG: The delivery guys keep batteries, arm pads and hardware like upholstery screws, bolts and nuts in their vehicles to make repairs on small things. And they have their tools all the time — diagnostic tools, too, like ohmmeters and programmers. Power chairs are self-diagnostic; the electronics are so advanced that you can plug something in and it’ll tell you what’s wrong. It’ll say the right motor’s disconnected, that’s why the chair’s not running. But you have to carry that tool to diagnose it.
MM: You’ve earned your accreditation through JCAHO. When you were going through the accreditation process, did you have to change anything in your service department?
RG: There were a couple of things they recommended we do in terms of segregating equipment so the dirty equipment doesn’t come in contact with the clean equipment. We had segregation, but they made more recommendations to us that we corrected immediately. They went through the service department and said, “Is this piece of equipment that your technician is working on clean?” In other words, has it been sanitized before we worked on it?
We said yes, but they said, “It doesn’t appear to be clean.” Well, this person uses his chair in the car and outside — he’s out in the dirt and dust, so (the chair) didn’t appear to be clean. We also had an area where we keep the stuff that’s going out for delivery and where we keep the stuff that’s being staged for repair — you need to make sure there’s a clear delineation of product. We use clear bags for clean equipment and tinted equipment for stuff that’s dirty, so we know where it goes or that this piece of equipment needs to be cleaned, and this one’s already been cleaned.
MM: Your city of Reno gets a lot of tourist traffic. What do you do when a visitor comes in with a service or repair need?
RG: When someone comes in from out of town, we normally do whatever we can to keep them going until they can get home to their own provider. If they have an issue with something we can fix, we might do it as a courtesy or we might loan them something while they’re in Reno, as a courtesy. We’ll try to keep them going, but they definitely need to follow up with their provider when they get home. If it’s a warranty issue, it’s best to keep their service continuous with their provider. There’s nothing worse than having to come in and fix something that someone else has done when you don’t know what’s been done in the past.
Now if the equipment was damaged by the airline and the airline is paying for it, we’re going to do whatever we can immediately. Then it’s not a Medicare issue. We also rent power mobility devices to people from out of town — strictly for their mobility in the community. That’s a separate retail business.
MM: This is a lot of work — clean and dirty equipment segregation, inventory decisions, intake, Medicare policies, repair claims. Does it take a certain mindset or personality to want to go into mobility and rehab service and be good at it? To dedicate your business to it?
RG: I can’t see how you can be in this business and not be in service. I can’t. How can you sell somebody something that you don’t plan on fixing? How can you sell a kid a wheelchair, and when he says it doesn’t fit or needs a part — how can you say, “Sorry, you need to call someone else”?