(c) Lieber/Weil2008

Compliance, Cash and Compliance, Cash and Reimbursement – Yes, Reimbursement – Yes,

You Can Have All Three You Can Have All Three

Miriam Lieberand

Colette Weil

(c) Lieber/Weil2010

Seminar ObjectivesSeminar Objectives

Examine opportunities in operations and marketing to build cash sales

Discuss cash sales situation with reimbursables– Ex. wheelchair, oxygen and bed

Review how to selectively use ABN Explore how to build cash sales mentality into

your operations and marketing efforts

(c) Lieber/Weil2010

Current MarketplaceCurrent Marketplace

Operations Audit frenzy Compliance focus Competitive bidding

uncertainty Convoluted third party

payer contracting – Smaller coverage

percentages– More patient out of

pocket

Marketing Patient/consumer/

referral source information paucity

Clarity in service/products offered

Revenue diversification Media changes Data analysis for

revenue enhancement Strength of relationships Where to invest

(c) Lieber/Weil2010

Patient (Consumer) Patient (Consumer) ExpectationExpectation Who defines patient expectation– Third party payer– Competitors– Media– You

Patient vs. consumer view– Patient managed, consumer responsible

Other healthcare providers approach– Cash up front– Participating provider– Service primarily– Do not sell other items outside of service necessarily (soft sell)

(c) Lieber/Weil2010

Getting from Patient to Getting from Patient to Consumer Consumer What do other healthcare services do? – Ask for the money upfront– Contact info, email info, complete post card for notification of

service or event

Approach as consumer and from your consumer’s viewpoint– Choice– Referral driven or recommendation– Services provided– Education on what is paid for– What other consumers purchase with primary item

• Why, how, when– Selection, price, service mix

(c) Lieber/Weil2010

Referral ExpectationReferral Expectation

Satisfy patient No complaint calls to office Unaware of products/services to help patient– Time/care/interest?

Little time to spend on your issues– Just wants patient taken care of

Doesn’t want to be second guessed Doesn’t want to owe you anything!

(c) Lieber/Weil2010

Educating Referral in Educating Referral in Consumer ChangesConsumer Changes Presentation is key!– New products, new hope – cash expected

Explain changing regulations Fewer dollars available from third party payers Increase in consumer’s financial responsibility – Equates to increase in consumer’s desire for

knowledge Redirect consumer into understanding their needs

can be met if they are willing to pay– Asking for the money up front is an absolute

necessity!

(c) Lieber/Weil2010

Up Front Insurance Up Front Insurance Gathering = Educated Gathering = Educated Intake Intake Must verify insurance up front Solidify payment arrangements before rendering

service– Even if patient has to wait

Make educated decision about what to provide patient

Obtain medical necessity documentation at intake

– Ensure payment – Time to retrain staff and referral community

• After all, other health care providers simply expect the cash!

(c) Lieber/Weil2010

Asking for the Money Is Asking for the Money Is Not TabooNot Taboo What’s good for the doctors is good for HME Expect cash Employ professional, matter-of-fact style Once you know how much to expect, you know how

much to collect up front If patient doesn’t pay, why render additional

supplies?– Must check outstanding balance when patient calls

for supply refill If you don’t ask, you definitely won’t get!– Human nature

(c) Lieber/Weil2010

Legal Guidelines: Marketing to Beneficiaries (“Benes”) – What You Can Do May contact by telephone and email if

one of the following exists:–Beneficiary has given written

permission–Supplier previously provided covered

item to beneficiary and supplier is contacting regarding covered item–Supplier has furnished one covered

item in past 15 months

(c) Lieber/Weil2010

Current Customers are Best Source for More Business

Current referral sources change jobs and will continue to refer

Current customers refer – after 10 purchases, that customer has referred 7 customers to you

Regular customers are worth five to six times more than anyone else

Increasing a customer retention rate by only 5% can boost the average customer net present value by an astonishing 35% to 95% (Source: Bain & Company: Microsoft Business for Small

and Mid-Size Companies)

(c) Lieber/Weil2010

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Customer Service Easy Customer Service Easy Follow-UpFollow-Up Gathering email at intake is critical Follow-up timing Personal letter, phone call, versus email– Age dependent

Complete post card for next notification Make sure you know where to find

customer/caregiver – Next of kin – cell phone, email, text

Reiterate promise/plan– Follow-through is key!

(c) Lieber/Weil2010

How to Ask/Presentation How to Ask/Presentation is Key is Key

CSR– Start with one primary Medicare item– Phone script

• See Tammy Zelenko’s Seminar (Increasing Cash Flow through Cash Sales)

• Prepared follow-up method –Letter/email/postcard

Retail sales person– Merchandise for easy demonstration– Show items for need

• Testimonials

Set incentive– Monitor for one month - Track sales

(c) Lieber/Weil2010

Cash Sales and Cash Sales and ReimbursablesReimbursables Hospital Beds– Sheets– Pillow– Sheet lifter– Egg Crate Cushion– Bed tray/caddy– Over the bed table– Urinal– Reacher– Briefs

Consumer approaches– Checklist (BB&B)– Testimonials and

examples– Stories– Visuals– Staff picks

(c) Lieber/Weil2010

(c) Lieber/Weil2010

Cash Sales and Cash Sales and ReimbursablesReimbursables Wheelchair–Gel or Foam cushion– Tray– Underneath Pack– Transfer board– Ramp – Bath items

(c) Lieber/Weil2010

Cash Sales and Cash Sales and ReimbursablesReimbursables Oxygen – Over the bed table– Footrest– Bed pillows– Pedlar

(c) Lieber/Weil2010

(c) Lieber/Weil2010

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General Cash and General Cash and reimbursable itemsreimbursable items Walker– Pouch/utility– Specialized tips– Basket/pouch– Tray

Commode Shower chair– Floor mat– Hand held shower–Grab bar– Back scrubber

(c) Lieber/Weil2010

Diabetic Supply Add-on Diabetic Supply Add-on SalesSales

Item HCPCS Care Reimb. Cost Care Allow. MSRP  

Home blood glucose monitor E0607 Y 70.16*  

Test strips (50/box) A4253 Y 38.79* 33.43* KL

Lancets (100 ct) A4259 Y 12.66*  

Heel/elbow protector   N    

Pedlar Exerciser   N    

Sugar free candy - assorted fruits   N    

Diabetic Lotion - 6 oz.   N    

Diabetic sock overcalf (size S,M,L)   N    

             

             

*Ceiling allowable          

(c) Lieber/Weil2010

Medicare Compliant Consumer It’s OK to have Medicare consumer buy non-

covered product If patient wants a Medicare covered item but

does not want Medicare billed, use ABN and option 2

Some are willing to pay after they are informed of Medicare guidelines– Transport chair example

(c) Lieber/Weil2010

How to Selectively Use How to Selectively Use ABNABN Patient choice Your protection Do not coerce Explain carefully No “blanket” or “generic” ABN but specific use

with legitimate payment doubt is acceptable Form is often completed incorrectly– Use valid reason – script ok – preprinted reason

ok– Audit for validity

(c) Lieber/Weil2010

Existing Patient ValueExisting Patient Value

Patient’s primary reimbursables New emphasis on total patient with consumer

needs over time/life Additional patient/family purchases– Tracking cash purchases by customer #– Sample of 10 patients, no CSR

• 10 patients with CSR contact

Frequency of contact Average length of relationship Impact on cost analysis of grandfathering

(c) Lieber/Weil2010

Marketing for Maximum Marketing for Maximum Return Return

Demographics and media matter Promotional incentive guidelines for

prospective and current Medicare patients, $10 retail per item, $50 retail max per year

Sales on cash items, bundling, free with purchase

Manufacturer donated items Valuable content to help in decision-making

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What’s Your Plan?What’s Your Plan?

Primary items/needs to tackle Assess target customers in database Determine what is the best method of contact for your

audience Lay out script Materials to be used Practice Incentive Test Measure Let it roll and count cash

(c) Lieber/Weil2010

Speaker InformationSpeaker Information

Miriam LieberPresident: Lieber Consulting15030 Ventura Boulevard, #786Sherman Oaks, California 91403818-789-0670818-990-9466 (fax)Email: Miriam@Lieberconsulting.comWebsite: Lieberconsulting.comFacebook: miriamlieberconsulting

(c) Lieber/Weil2010

Speaker InformationSpeaker Information

Colette WeilManaging Director: Summit Marketing3 Marsh Drive, Mill Valley, CA 94941415-388-5303415-388-2675 (fax)Email: cweil@summitmktg.comWebsite: summitmktg.com