Revenue Enhancement Resources
InnovaMed Services, Inc.
DME Outsourcing Program
The InnovaMed Services (IMS) DME Outsourcing Program is a convenient service program designed specifically for orthopedic, neurological, and podiatric surgeons as a solution for providing DME products to assist patients in the rehabilitation phase pre/post-surgery. IMS is not a medical provider. IMS is an independent contractor providing equipment and services to physicians who want to outsource their DME services and equipment needs. The physician is the DME provider. Following are the products we offer:
- SCD/Cold Therapy/Joint Compression – Work Comp/UHC/Tricare
- sam Sport Portable/Wearable Ultrasound Device – Work Comp Only
- Quad Stim Device with Conductive Garment – Work Comp Only (to be set up in physician office by practice employee)
- Bracing products – Commercial insurance/Medicare (if practice has Medicare DME license)
- New products for evaluation as they become available
The primary benefit of our program is that this allows the practice to take advantage of outsourcing the DME service component while eliminating the need to inventory capital intensive equipment requiring routine service and maintenance. Our mission is to help medical practices capitalize on unrealized revenues that are routinely referred to outside DME providers.
Business Model: The physician practice is the DME provider and IMS sells or rents equipment to the practice for a fee that includes: (1) the purchase or rental cost of the equipment and (2) the patient services. IMS is responsible for preauthorization of claims, as well as billing and managing accounts receivable. All insurance reimbursements are paid directly to the practice and all mail will come to the practice regarding the claims. IMS will invoice the practice for each patient processed with payment due upon receipt of the claim by the practice. Estimated net monthly revenue per claim for the practice ranges from $500 to $1,200 per claim after payment of the equipment/service fee to IMS, depending on products ordered and insurance reimbursement.
Our service department will provide the DME products to the patient, to the physician’s office, or to the surgery center prior to surgery.
Our patient services include delivery to the patient/caregiver, instruction on the proper use of the device as well as providing written instructions and online user videos. We will answer all patient questions and concerns to ensure that they are able to properly use the product. We are available 24/7 for questions and service issues. The patient will sign and date the physician’s proof of delivery, assignment of benefits, and notice of required patient disclosures. IMS has professional and general liability insurance limits of $3M/$1M and will provide a Certificate of Insurance to the practice.
Please call IMS at (800) 386-1978 or email at firstname.lastname@example.org if you have any questions or need additional information.
Revenue Generating Fall Prevention Program
Capital Medical Corporation
Fall Prevention Rollout
Clinic/Hospital/LTC Based Fall Prevention Program
- Revenue Generating Program for Physician
- Meets 3 of the 6 High Priority MIPS
- CPT Code 97750 with GP Modifier, 2 units
- Increase referral for ancillary services including Physical Therapy
Capital Medical Corporation has been a provider of Home Medical Equipment since 1994, concentrating in orthopedic rehabilitation equipment and bracing. CMC is now helping orthopedic practices implement a comprehensive fall prevention program aimed at reducing falls in the general population while helping physicians improve their MIPS (Merit-based Incentive Payment System) scores to avoid being penalized for low scores. MIPS annually scores eligible Medicare Part B clinicians on a 100-point performance scale which results in a Composite Performance Score (CPS). The higher the score the better. MIPS is designed to be a budget-neutral program, but there is $500 million allocated to provide additional incentive to exceptional performers- those earning 85 or more points in 2020. We can help the practice improve their MIPS score for three of the high priority ratings; 318, 154, and 155.
Did you know:
- In 2014, falls cost the US Medicare system over $28B in 2014 and total costs due to falls exceeded $42B.
- In Florida alone in 2014, Medicare incurred over $3B in medical costs associated with falls with total costs due to falls at just under $4B.
- Fall prevention is a huge priority with Medicare because these costs are expected to rise dramatically in the coming years if steps are not taken to protect our seniors!
CMC can institute a fall prevention program in your facility, including a patient questionnaire, assessment by qualified medical personnel, and provide a report for the physician to briefly advise the patient on their risk assessment and proactive steps to help protect their patients from a fall, which could have a severe impact on their lives.
CMC can provide this program for your facility for every at-risk patient over 55 years of age and have an assessment conducted up to 4 times a year or for surgical patients, during the pre-op, the day before surgery, and at their follow-up after surgery.
We can initiate our program at your facility in a number of different ways depending on your level of involvement.
First, we can show you how to use the program to conduct the assessment and net up to $42 per patient. You will assign staff to conduct the assessment and the physician will report to the patient. Second, we can show you how you can implement the program and CMC will assist you in staffing the assessment positions and the physician will report to the patient. In this scenario, CMC will bill the practice for the cost of the staff provided to perform the assessments. Third, the practice can utilize CMC to provide all aspects of the analysis including absorbing the cost of the staff and the software fees. CMC can bill for the fees using the practice provider numbers and when the practice is reimbursed by the payer, the practice will pay the amount received to CMC. Otherwise, the practice can do the billing and pay CMC 90% of the gross amount collected.
The important outcome of each of these approaches is that your patients are utilizing the most effective tool available to assess and educate them on how to best prevent falling.
Additionally, implementation of a comprehensive fall prevention program by your practice can be used as a marketing tool to make your community aware of the steps you are taking to help your patients prevent avoidable injuries by making a few adjustments in their activities and to be aware of conditions that may make a fall more likely to occur. Please call CMC at 850-386-1978 or email us at email@example.com. Thank you.