Reliable Medical Grows with the Support of Brightree Solutions

Improved automation and financial performance insight deliver billing efficiencies

Reliable Medical Equipment provides one-stop shopping for home medical equipment and services, including state-of-the-art products in the oxygen, CPAP, mobility and other categories.

With two locations in South Carolina and just over $1 million in sales, Reliable saw the opportunity to expand its business. However, the Reliable team realized its Home Medical Equipment (HME) billing software would not support its growth plans. The system did not provide adequate reporting, and the Reliable staff had to resort to manual, handwritten processes for producing critical documents such as delivery tickets and Certificates of Medical Necessity (CMN). Reliable implemented the Brightree cloud-based billing and business management solution to help support its growth. The company grew to four locations and $8 million in revenue in 2010.

“The Brightree system is more intuitive and powerful than other systems and offers us the level of automation we need,” says Tamra Maxfield, district manager of Reliable Medical Equipment. “It has played a critical role in our growth to date, and we are confident that it will help us navigate the regulatory and reimbursement challenges ahead of us.”

Streamlining processes, optimizing operations

Brightree’s solution is specifically developed to optimize workflows and maximize billing results for the HME industry. After implementing Brightree, Reliable was able to streamline processes, automatically submit claims, and manage interactions with physicians, patients, and insurance companies through one system. In addition to the core billing solution, Reliable has optimized its use of Brightree with extended services, such as electronic faxing, electronic claims processing, document imaging and ERA auto posting.

“Being able to use Brightree’s integrated, electronic faxing solution for getting our CMNs to and from the referring physician in a more efficient manner has helped us dramatically reduce the time we spend collecting these important documents,” says Maxfield. In return, Reliable has reduced its held A/R. Now the typical amount of time invoices spend in held A/R is 12 days, which is considerably lower than the industry average of 35 days.

An impressive reduction in DSO

While the day-to-day time savings with Brightree have been significant, the real benefit to Reliable’s bottom line is being able to submit claims and collect much faster than before. Since implementing Brightree, the company has reduced its days sales outstanding (DSO) from 85 to 56 days—well below the industry average of 70 to 80 days. “Brightree enables us to quickly get orders in the system, update inventory and generate essential reports. We run an outstanding sales order report and know what payments we can expect,” notes Maxfield. “Our entire process is more efficient, which has made a direct impact on improving our DSO.”

Reporting and management capabilities improve operations

Another distinct Brightree advantage is the advanced reporting that provides the visibility needed to make more informed business decisions. And, Brightree’s ad hoc reporting capabilities can be easily customized to address Reliable’s unique reporting needs.

According to Maxfield, “Brightree’s reporting has given us insight and answers that we need to the tough questions, such as are we generating more sales than normal? Are rentals down? Who are my best referral sources? What are our trends in returns, held A/R and DSOs?”

As the operations manager, Maxfield values being able to stay on top of what’s going on in the companies’ four branches. Brightree’s cloud-computing model gives her a leg up here too; it provides anytime access to information. She adds, “Since it’s web-based, I can work anywhere, even in the car going from branch to branch – as long as someone else is driving!”

The system’s Business Scorecard helps Reliable monitor trends in the company’s denial rates. “By having instant access to a snapshot of my business, I am able to monitor things like denial rates. I can also drill down to see the sources of the denials and direct my staff to take action on priority items. This has enabled us to improve our overall collections and cash position.”

Cutting down on Same or Similar cuts down denials

Reliable found that the most common reason for many of its claims being denied by Medicare was Same or Similar. If an order came from a hospital for a rolling walker, the staff would have to call the Medicare IVR system to get the approvals they needed. Often, this could take between 10 to 20 minutes and sometimes multiple attempts. In some cases, Reliable would take the risk and make the delivery before contacting Medicare, which could result in returns.

With Brightree, Reliable is able to check Medicare eligibility online, including Same or Similar. If a claim is denied, detailed reasons are easy to find. The claim can be quickly reviewed, corrected and resubmitted. These capabilities have helped reduce Reliable’s denials by 30%.

Easing the burden of compliance and ever-changing guidelines

The Brightree solution helps Reliable keep up with changes to reimbursement rates and ongoing compliance guidelines. “Brightree is on top of the changes constantly occurring in the industry, so we know we always access the most accurate and up-to-date information. And updates to the system are generally made without us having to do anything. This saves us time and money.”

Brightree automatically updates Medicare price tables the first day of each quarter and also maintains diagnostic and procedure codes. The current, accurate price tables allow Reliable’s A/R reports to be as precise as possible.

Managing growth

As part of its growth strategy, the company recently went through a merger. The Brightree solution helped Reliable embrace the new customers and orders seamlessly. “We were able to go into the system, enter a sales order initial load for the new accounts, and start the billing right where it left off. That would not have been possible with our previous solution,” said Maxfield.

In addition to the Brightree solution’s flexibility, Maxfield appreciates the customer service that is only a phone call away. She knows that she can count on Brightree to support Reliable’s needs, whether there’s a technical question or a need to add another application. “While patients depend on us for the equipment that’s essential to their health,” she says, “we depend on Brightree to help us manage our business.”