[fchoate]

Our Children’s Homecare Team is working on an improvement project to decrease unsigned Delivery Tickets. We are an “integrated but separate” Hospital division – so we actually deliver the DME / Rx.

In my humble opinion, the issue has come down to communication with the Families. Does anyone have a set of “Best Practices” or know where to find some? I’ve looked for some industry standards, but have come up short. [Without benchmarks, who’s to say we’re running our business effectively or not?]

Some sample questions which need clarified are:

· Where are the points of Patient contact and communication?

o Do you call Patients to advise them a refill is due – or do they call you to request?
o Do you have an initial sit downs with Patients, “Welcome to HomeCare, here’s what to expect…”

· How do your Patients know you’re delivering?

o Do you provide “Delivery Promise times” based on a schedule? (like the cable guy)
o Do you leave supplies at the home and instruct the Patients to sign delivery ticket & return via SASE?
o What (if anything) can be left on the porch like UPS?

Thanks for your any help on the above.
Warm Regards, Franklin

[DMEisgoodfun]

For industry benchmarking look up Jack Evans and Bruce Brothis. Jack is a
"front of store" guy while Bruce is "back office." Google 'em. They both
have great articles and information out there.

Unsigned delivery tickets - unacceptable. Staff needs to be retrained.

Points of contact and communication - Medicare has rules about when we can
and can't contact clients. As providers, we're all making business decisions
about how far we want to push those rules and how we want to coordinate
serving our clients.

Letting patients know you're delivering - I've worked at multiple DME's &
they all do it differently. The happiest clients are informed clients so
it's best to give them a window. Keep them informed if something comes up.
You can use UPS tracking # as your proof of delivery or you can choose to
use SASE, however, if the client doesn't return the signed form, you can't
prove delivery was made.

Initial sit down - This is your intake. Anytime we bill an insurance, we're
doing an intake that will take 10-30 minutes. This is where you review their
insurance benefits, coinsurance/deductible, the Assignment of Benefits,
waivers if applicable, product care/warranties, rental agreements, Patient
Rights & Responsibilities, etc... All the good stuff we're mandated to do.

[JoeyGraham]

Here's some information based on our business. I agree with the previous comment about Jack Evans (retail) and Bruce Brothis (billing guru). We've worked with Bruce before and he's really good.

· Where are the points of Patient contact and communication?

o Do you call Patients to advise them a refill is due – or do they call you to request?
Depends on your business goal. Some patients just don't make business sense to call (ie. BCBS of AL CPAP patients - supplies are bundled with the CPAP rental so you can't bill for them separately - money loser; however, we call all of our Medicare patients religiously because we can bill for the supplies). If you want to initiate the order, go ahead and call them. Just make sure you document that they want a refill as well as how many supplies they have left and adjust either the delivery date or quantity to ship based on the information they give you.
o Do you have an initial sit downs with Patients, “Welcome to HomeCare, here’s what to expect…”
Yes, our delivery technicians sit down and go over the HME with the patients and families. This is when they get all the paperwork signed. In addition, our CSRs discuss it with them over the phone.

· How do your Patients know you’re delivering?

o Do you provide “Delivery Promise times” based on a schedule? (like the cable guy)
We try not to "promise" delivery times because that just sets you up for disappointment; however, we also don't give patients giant windows like the Cable guy (ie. we'll be there some time between 8AM and 5PM). Our technicians call the patients and let them know they're on the way and how many orders they have before they can get to the patient with an estimated delivery time. They also call when they're on the way (ie. next order).
o Do you leave supplies at the home and instruct the Patients to sign delivery ticket & return via SASE?
NO... bad bad idea. We don't leave the home unless we have a signed ticket in hand, even if we had to get the neighbor to sign it. Otherwise we're not leaving our stuff there. There have been situations where something is wrong with the signed ticket so we'll mail them a new ticket with a SASE and ask them to sign and return it, but this is very rare.
o What (if anything) can be left on the porch like UPS?
Nothing you can bill for or might need for compliance reasons. For example, we may leave Cannulas and tubing in a bag hanging on the door, but we would never do that with a billable item or with an oxygen cylinder (not billable, but a controlled substance).

I hope this helps,
Joey

[SimplyLori]

We use SASE and what we call SWMYs (sorry we missed you notes). I hate having to track down the ones that don't get returned and delay our billing but with the cost of delivering we need to keep to our routes. We just finished a QI study on these and are still making changes. Repeat SWMYs have to get UPS'd or flat rate postal but if its too costly we have to rework our delivery times. Important Note - We were burned in a Blue Cross audit when we discovered that the tracking numbers from US Mail didn't work after 6 months. We had to get signed avidavits on every single order to keep from refunding the money!