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DME Case Study

When Piles of Paperwork Block the Road to Revenue

How a Leading DME Provider Turned Manual Processes into Millions in Savings

MediStreams offers a revenue cycle management solution for durable medical equipment (DME) suppliers that transforms manual, inefficient payment and remittance processes into automated workflows, reducing the time and cost of getting paid. The MediStreams platform lets clients manage, automate, and accurately capture and reconcile both paper and electronic payments.

With more than 700 provider locations and 500 integrations with banks, clearinghouses, and practice management systems, MediStreams uses their experience and expertise to deliver accelerated speed to value with measurable ROI. Here is a recent example of how a major DME supplier was able to accelerate revenue, save millions of dollars of back-office expenses, and reduce manual work.

The Industry Challenge

Durable medical equipment suppliers (DME) have a built-in challenge: how to process the thousands of correspondence pieces they receive (and send) daily, as well as how to manage unstructured documents.

Picture the variety: from medical records to appeals, from authorizations to audit notices, from returned mail to notification of a deceased patient. If a company doesn’t have a good way to quickly identify the content, important information can sit in piles – on desks, in boxes, or even in online storage – and block progress while draining revenue.

Partially Automated Systems Equal Lost Revenue and Increased Risk

One of the largest durable medical equipment suppliers in the country faced that paperwork challenge. The company had an existing solution for paper EOB conversion (Explanation of Benefits), but that solution didn’t convert, manage, or organize their full range of correspondence. Without the ability to quickly find and sort key documents by type and content, they were spending a lot of time and money managing manual and inefficient processes.

They were also unprepared for audits, and in fact were missing deadlines, which significantly impacted revenue (for certain types of audits, you must reply within 45 days, or you lose any chance of appeal). Fraud is so prevalent in healthcare (costing billions of dollars’ worth of losses each year, according to the National Health Care Anti-Fraud Association), that audits by the Centers for Medicare and Medicaid Services (CMS) are growing increasingly common. And now that the public health emergency related to the pandemic is over, experts expect audits to increase.

Automation for Full Access and Transparency

A large DME supplier asked MediStreams to transition their partial solution to one that would cover all of their documents. MediStreams implemented its Correspondence Solution, which integrates with the DME provider’s bank lockbox (a secure way to handle payments) and automatically applies those payments to their patient accounting system. In addition, MediStreams automatically captures key fields (patient names, account numbers, etc.) and identifies the document type to allow providers to quickly find and act on important documents. On the MediStreams web portal the DME supplier can view, route, assign, and manage their correspondence documents and audit notices in a streamlined work queue, whenever and wherever they need to.

The Right System Saves Money Every Month

The potential for savings by using the MediStreams solution is in the millions of dollars. After less than a year, a similar-sized MediStreams client saw savings increase from $3,000/month to more than $100,000/month, both in posting costs and in opportunity costs related to responding to audits.

That same client also saved money by eliminating manual entry for zero pays. They were processing 30,000 zero pays/month with 10 full-time employees. With this complete platform, zero pays go directly into their digital files with no staff time required.

The teams report being much happier with the easier workflow, which is a big win for any employer competing for talented people.

What's more, the MediStreams solution significantly reduced lockbox errors and other issues through operational improvements that addressed the root causes of correspondence-related problems.

The Bottom-Line Benefit

In the DME industry, with audits happening on a routine basis, any DME handling remittance data through a bank portal or manually should explore the potential to save money and time in a way that’s measurable and repeatable with an automated revenue cycle management solution.

See how MediStreams can improve your revenue cycle and reduce your workload