Operational Assessment Tool - HME Provider

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Contact Information
* First Name : 
* Last Name : 
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Address 2 : 
City : 
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Phone : 
Email Address : 
 
 
 
Company/Organization Name
   
Phone Number
   
 
 
 
Welcome to our exclusive Operational Assessment Tool - this tool  has been specifically designed to address the unique business model and operational challenges of HME providers. 

Some questions will contain a question mark icon - simply click on the question mark icon to learn about best practices relating to that specific question. 

Once you have completed and submitted the self-assessment, you will receive a completed operational analysis that will identify specific and general improvement ideas that you can consider as a part of your operational and performance improvement initiatives. 
 
 
 
General Information About Your HME Business
 
 
 
How many FTEs (full-time employees) do you have? not including those in formal leadership roles
 
 
 
Describe your leadership structure (i.e., how many supervisors/team leads do you have)?
   
 
 
Do you have an operations manager responsible for overall day-to-day operations? 
 
Yes
 
No
 
Other
 
 
 
 
Do you have more than one location (multi-site) 
 
Yes
 
No
 
Other
 
 
 
If you indicated you have more than one location, are your intake/CS functions centralized into one location? 
 
Yes
 
No
 
Other
 
 
 
 
Briefly describe your payer mix: (i.e., 30% Medicare, 10% Medicaid, 15% private pay, etc.)
   
 
 
 
What types of equipment and supplies do you provide (Select all that apply)?
 
DME (beds, walkers, wheelchairs, commodes, etc.)
 
Oxygen
 
CPAP and Bi-level
 
Ostomy supplies
 
Wound care
 
Diabetic supplies
 
Breast pumps

 
 
 
Please tells what other types of equipment, supplies, and services you provide:
   
 
 
 
Do you have a retail operation?
 
Yes
 
No
 
Other
 
 
 
 
If you indicated that you do have a retail operation, what is the approximate total square footage?
   
 
 
 
What software system do you use? 
 
 
 
Do you feel as if you are fully leveraging/using all of the features you should be using in your software system?
   
 
 
 
Do you currently use any other software? 
 
Medforce
 
Conduit
 
Strategic AR
 
Other
 
 
 
Do you use an automated patient contact service (APCS) to engage and follow-up on patients?  (PAP compliance, re-supply, routing f/u, etc.)

 
Yes
 
No
 
We use APCS for some, not all patients (provide more detail in "other" box below
 
Other
 
 
 
 
Do you have a document imaging system in place?  (are you scanning/digitizing documents or are you still paper-based)? 
 
Yes, we are scanning nearly all of our documents
 
Yes, we scan most, but we still rely some on paper
 
No, we are not scanning (we are completely paper-based)
 
Other
 
 
 
 
  Intake/Customer Service 
 
 
 
Are the intake/CS team members responsible for processing insurance and documentation tasks? 
 
Yes
 
No
 
They process some of these functions, but not all (provide additional detail in "other" box below
 
Other
 
 
 
 
How many people work in your intake/customer service area?
 
 
 
How do you track/monitor the performance of your intake/CS team (Select all that apply)?
 
Track # of orders processed
 
Track call volume
 
Track # of orders by order type
 
Track # of delivery tickers or work orders complete
 
We don't really tack anything in this area

 
 
 
Please tell us what other metrics of information you collect regarding the performance of your intake/cs team:
   
 
 
 
Do you utilize a phone software system?
 
Yes
 
No
 
Other
 
 
 
 
How do you manage/process incoming calls? (do you use a menu system or live answer)? Do all incoming calls go to a single person(s) such as a receptionist, or do they go to a call group?
   
 
 
If you indicated that you do have a phone software system, what type of phone metrics do you collect?
 
# of abandoned (dropped) calls
 
Avg. hold time
 
Total calls received (either daily,monthly)
 
Daily call volume per CSR
 
Avg. time per call
 
 
 
What are your primary sources for referrals?  (Select all that apply)
 
Physician
 
Payers
 
Discharge planners/social workers (hospital-based)
 
Clinicians
 
Clinics
 
Other
 
 
 
 
How do you manage and process faxes? (do you use "paperless faxes" such as a desktop faxing software)? Do you use digital faxing as part of your software system?
   
 
 
 
On average, how many cancelled orders do you have per month?
   
 
 
 
How do you define a "cancelled order"?
   
 
 
 
How do you check and verify insurance eligibility (Select all that apply)?
 
We use an online and automated phone service for most of our transactions (IVR, other)
 
We use the verification tools that are included with our software
 
We try to use automated methods as much as possible
 
We still do a majority of our verification via the phone

 
 
 
Please provide any additional information about how you process insurance verifications and eligibility:
   
 
 
 
At what point in the process/workflow do you determine and notify the customer of their co-pay?
   
 
 
Do you collect the entire copay amount upfront (all at once) or do you provide options for paying the co-payment?
 
We collect entire amount upfront
 
We are flexible - provide options to customer
 
Other
 
 
 
Do you have a patient payment portal? 
 
Yes
 
No
 
Other
 
 
 
 
Do you outsource all or any part of the co-pay/patient payment process?
 
Yes
 
No
 
Other
 
 
 
 
Do you provide a new patient informational packet to new customers? If so, what is included in this packet?
   
 
 
Do you have a dedicated intake/CS supervisor or team lead?  (someone that is always available to assist with questions and resolves issues)
 
Yes
 
No
 
Other
 
 
 
 
Describe any issues, barriers, or "pain points" that you commonly experience as part of your intake/CS area: (consider workflow, capacity, workload, errors, accuracy, communication, etc.)
   
 
 
 
Insurance Verification and Documentation 
 
 
 
How do you collect documentation and information? 
 
 
 
Do you rely on sales or "physician liaison" team members to assist with obtaining signatures and documentation? 
 
Yes
 
No
 
Other
 
 
 
 
Do you have a Q/A (quality) check process or step in place to ensure that all required information and documentation is present (prior to providing the order/service)?
   
 
 
 
Describe any issues, barriers, or "pain points" that you experience within your insurance/documentation area:
   
 
 
 
Financial Information 
 
 
 
What is your gross revenue per employee (FTE)?
   
 
 
 
What is your total yearly gross revenue?
   
 
 
 
What is your average per month COGS?
   
 
 
 
What is your current DSO (days sales outstanding)?
   
 
 
 
What is your average monthly cash collection amount?
   
 
 
 
What are your total average monthly expenses? (include both variable and fixed cost expenses)
   
 
 
 
General Operations 
 
 
 
What methods and people do you use to deliver equipment to clients? (for example, do you use a courier service for certain delivery types or for routine pick-ups)?
   
 
 
Do you use a Point of Delivery system?
 
Yes
 
No
 
Other
 
 
 
 
Do you have a route management system in place?
   
 
 
 
What type of metrics do you use to monitor delivery/service technicians? (for example, stops per day, miles driven, # of pick-ups, etc.)
   
 
 
 
What is the average TAT (turnaround time) for paperwork coming from the field back to the office?
   
 
 
 
Are your core processes standardized and formalized? (consider intake, evaluation, purchasing, scheduling etc.)
   
 
 
 
Describe any process improvement work that your company has completed (or started) in the last 12 months:
   
 
 
 
Do people tend to follow established processes and defined procedures? (consider how they perform and carry out their daily work - are they consistent, not using workarounds, etc.?
   
 
 
 
What is your most significant operational challenge?
   
 
 
 
Purchasing and Inventory 
 
 
 
Do you utilize a bar coding system for inventory 
 
Yes
 
No
 
Other
 
 
 
 
Do you rely on your software to manage inventory (perpetual system) or do you rely primarily on manual processes to manage inventory?
 
Primarily system-driven
 
A mix of system and manual processes
 
Primarily manual processes
 
Other
 
 
 
 
Who is responsible for ordering/purchasing equipment and supplies?
 
We have a dedicated purchasing person/department
 
Other
 
 
 
 
Who is responsible for scheduling evaluations? Who is responsible for scheduling deliveries of custom wheelchairs?
   
 
 
 
Billing & Reimbursement 
 
 
 
Do you outsource any portion (or all) of your billing?
   
 
 
 
How many billers do you currently have?
   
 
 
 
What percentage of your claims are submitted electronically?
   
 
 
 
Where in your order receipt to deliver process does the confirmation step occur?
   
 
 
 
On average, how many orders per day are confirmed? Do you confirm orders every day? How many people are available to confirm orders?
   
 
 
 
Do orders generally get confirmed the same day or no later then the next business day - if not, why not?
   
 
 
 
Where in your order receipt to deliver process does the confirmation step occur?
   
 
 
 
Audits 
 
 
 
Do you have a designated person or persons responsible for working audits?  (this would include responding to and managing/monitoring audits)
 
Yes, we have a person or a group that manages audits
 
No, we respond to audits as they come up
 
Other
 
 
 
Do you have a "self-audit" process in place? (a proactive Q/A process that mimics a real audit)
 
Yes
 
No
 
Other
 
 
 
 
Leadership & Performance Management 
 
 
 
Do you have a formal performance evaluation process in place? If so, how often do you provide employee performance reviews?
   
 
 
 
Do you use supervisors or team leads in different areas (for example in intake/CS, billing, warehouse, etc.)  Please provide additional information as needed in the "other" box. 
 
Yes
 
No
 
Other
 
 
 
 
Do you (or have you) provided leadership training for your leaders?
   
 
 
 
Do you have clearly defined and reinforced performance expectations for your leaders?
   
 
 
 
Please provide any other additional information, insight, or concerns that you may have that will help inform how we prepare your customized operational assessment summary: