Howard’s beats industry billing standards by 60%!

No medical supply ever publicizes their billing numbers; however, I want to let everyone know what the team at Howard’s is up to. According to CMS standards, on the first round of audits for Medicare, the average durable medical supply has 85% of their claims denied by Medicare when they are audited. Now, there are four rounds of appeals, so even though this means only 15% of claims are paid on average in the first round of appeals, it gives you an idea the number of claims Medicare denies that comes across their books.

Last week, Howard’s Medical received our numbers for the last forty-five days. We are running at a 25% denial rate for our Medicare claims, a full 60% better than industry average!

How do we do it?

  1. We communicate with your providers and know the rules for billing equipment inside and out in regards to medical supplies. Just as you want your accountant to know the tax rules inside and out, we know medical supply rules inside and out.
  2. We have an amazing team. They take the time to verify your eligibility, work with you when you are in the store, ask the right questions so when we bill your claims everything goes through and it gets paid.
  3. We also know when an item is not going to be covered. For example when a patient is in a nursing home or hospice, Medicare does not cover most medical equipment.

One other question you might wonder, a 25% denial rate still seems high. You are right, it is. A few other thoughts on this:

  1. There are multiple rounds on the appeals processes when we bill claims. The 75% success rate for Howard’s is just for round one. If we have one of your claims and we fail in round one, we look to see why we failed, verify the reason and sometimes it is a very simple reprocessing of the claim. Other times we have to contact your provider and ask for addendums to chart notes. Worst case scenarios we do have to pick up equipment.
  2. Other insurances for the most part are significantly easier to bill than Medicare. So if you don’t have Medicare take heart, life is much easier for the billing side of things for your medical supply company.
  3. Medicare is slowly working on things. There are a number of bills in congress working to streamline things. Please contact your senator and congressperson and ask them to ease up on the audits. We are not anti-audits because they prevent fraud but in high school if you get 99 out of 100 on a test this is an A+. With a Medicare audit, a 99 out a 100 is a failure that has to be fixed!

If you have any durable medical or respiratory billing questions, give the team at Howard’s a call, we really do know what we are talking about and have the numbers to back it up: 509-654-9899.

The “Why” Behind Kittitas Medical

Howard’s Medical formally announced last week we are opening a third location in Ellensburg. I am a “why” person so this post will seek to explain why we are opening a new location. 

Two years ago, we would not have considered moving to the Kittitas Valley. There was a great respiratory supply company (KVH Home Respiratory) and KittitasMedicala great local pharmacy that provided other DME supplies (durable medical equipment) and billed Medicare. Both companies have since stopped providing these items, so as of June 1, 2015 there is not a single DME storefront location in Kittitas County.

Ellensburg is similar to Selah where Howard’s Medical begin in 2004. They are both small towns where getting to know individual customers and providing excellent customer service still really matters.

Why call our new store Kittitas Medical instead of Howard’s Medical? Howard’s is a local name well-known to Selah residents since the late 50’s and we want Kittitas Medical to mean the same to the residents of Kittitas Valley. We are not going to be “just another business” in town, we want to come alongside you, serve you and help maintain your independence in the home for as long as possible. We will be available for consultation, instruction, and a kind word to help out.

We have signed our lease at 800 South Pearl in Ellensburg across the street from the Rite Aid pharmacy. To the north of us is the DSHS building which houses Canyonview Physical Therapy, Memorial Services Clinic, Dr. Jeffrey Ventre’s monthly wheelchair clinic, Pinnacle Sleep Center, and monthly visits from Cascade Foot & Ankle and Yakima Urology. Across the street from us is the Super 1 Grocery store. Behind us is the medical practice Family Health Care of Ellensburg.

Our main goal is convenience for the residents of Kittitas Valley. We are currently waiting on a permit to partition out part of our store, and we plan on opening August 1, 2015. We will employ a full-time, in-store Team Lead as well as a full-time Delivery Technician for those customers who cannot make it into the retail location. Both of these team members have just been hired and we will be announcing them next week so stay tuned!

We are looking forward to serving your family this year. Our slogan is, “Our family serving your family’s health care’s needs.” We don’t take serving lightly, so let us know what we can do to help you be as independent as possible, both inside and outside your home.

Sincerely,

Erik Mickelson and the rest of the team at Howard’s Medical and Kittitas Medical Supply

 

KVH in Ellensburg Discontinues Home Respiratory Program

Howard’s found out about two weeks ago that KVH (Kittitas Valley Healthcare) was going to discontinue their home respiratory program. Since Howard’s is a hometown and locally owned company, this broke our heart to hear their home respiratory program was closing their doors after serving their community for over twenty years.

Howard’s currently served Kittitas Valley once a week so we are planning on increasing our service to Kittitas County with daily deliveries Monday through Friday to compensate.  Here is their official press-release that was released earlier today.

We are also planning on hiring a full-time operations technician to be based out of Ellensburg.  If you know of someone who would be a great team member have them apply at Howards through our link on Craig’s List.

If you have any questions, please give us a call toll-free at 800-469-7131.

Erik

Team Lead for Howard’s Medical