Just What the Doctor Ordered:
MSM Adds Value to Supply Management Billing

The Challenge
A busy Massachusetts-based orthopedic clinic decided to streamline operations and move from managing its own DME billing to using an online third-party stock-and-bill program. From the start, there were issues with billing and third-party denials. Payer-specific changes weren’t made, and to make matters worse, there were repeated problems with coding compliance. The program also required that the clinic’s back-office staff change their billing processes, creating a significant learning curve that delayed bill submittals.

Adding to the technical inefficiencies and non-existent support, the stock-and-bill program limited the clinic’s DME supply to a single vendor. This restriction made it impossible for the clinic to find the most cost-effective and appropriate products for its patients. “We were doing all the work, but the vendor was collecting all the revenue,” says the clinic’s administrator.

The Solution
The clinic engaged MSM’s consulting services to unravel the mess the stock-and-bill program created. Working closely with the clinic’s administrator, MSM provided a value assessment of the clinic’s product needs, analyzing the value of the inventory and the associated revenue. Then, MSM’s experienced team tackled the billing errors— cleaning up the denials and scrubbing the codes to comply with Medicare claims.

When the clinic saw how MSM’s vendor-neutral policy gave them a wider selection of DME– along with associated cost efficiencies and revenue possibilities– they were sold.

As part of MSM’s comprehensive services, after setting up the solution for the clinic, the MSM team regularly followed up with the clinic’s administrator to answer questions, to provide training, and to ensure that the clinic was seeing the benefits from its supply management billing solution.

The Results
Today, with a well-trained staff, the clinic’s billings are accurate and on track— which results in timely payments. The clinic’s revenue participation has also significantly benefited the practice. MSM was able to uncover up to $1,922 in potential per patient revenue for a Surgical Anterior Cruciate Ligament (ACL). “Thanks to MSM’s consulting and supply management billing solution, MSM does most of the work and the clinic collects on the revenue!” says the clinic administrator.