We have made extensive investments in our technology to provide a world-class customer experience. Our state-of-the-art, proprietary technology systems create a paperless documentation process that allows us to efficiently and compliantly verify, ship and bill for products with minimal effort required on the part of the patient or health practitioner.
All customer information at HCD is stored electronically. This allows HCD to be able to respond to audit inquiries very quickly and enables payors to do their own audit inquiries. The “auto-audit” functionality is customized for each payor’s needs.
HCD provides a web-based portal that allows the payor to specify a set of recipient ID’s and a range of dates of service. Our systems then construct packets of information for each individual that include all clinical paperwork and the Proof of Delivery (POD) information for each shipment. This information is then either collated as electronic information and images and presented through the Web portal or printed and mailed to the payor for their review.
PayerPro® directs HCD customer care representatives in identifying what can and cannot be shipped compliantly. The greatest complexity in establishing and maintaining the optimal scheduled shipments for individuals is in the myriad of rules for each different type of insurance (payors). Some payors cover products for only certain conditions or in combination with other products. Some require additional documentation if quantity or cost levels are exceeded. Some payors have rules that only apply if the individual is also carrying insurance with another specific payor. Failure to follow these rules precisely may result in payment denials, delayed payment, under payment and/or penalties.
Most other companies rely on written procedures and the customer care representatives’ ability to memorize the rules and regulations. HCD has developed a system that works in tight conjunction with OrderPro®, making certain that all current and correct rules are followed. PayerPro® uses a graphical interface to allow the team managing HCD’s payor relationships and rules to set up extremely complex parameters for what can be shipped, how much can be shipped and when. This system significantly reduces the risk of staff making a mistake on an order, ensuring accuracy and regulatory compliance and the elimination of order delays due to ordering errors. Ultimately, PayerPro® directs HCD customer care representatives in identifying what can and cannot be shipped compliantly.
A critical component of HCD’s success in accurately and efficiently servicing individuals with recurring supply needs is our ability to properly manage each person’s ordering schedule, knowing which supplies the individual will need and at what frequency the items will likely be needed. HCD is acutely aware of the important balance that must be achieved in ensuring that individuals do not receive more product than they medically need. Deliver too soon, and the individual may be in possession of an excessive amount of supplies; deliver too late and the individual will not have the supplies they need to properly manage their medical condition.
In addition to properly scheduling all orders, we must make sure that our customer care representatives have the current and correct information to service each unique individual, and that all of the appropriate information is in the system for on-time delivery and proper billing. To handle these tasks, HCD created an order management system called OrderPro®, which tracks each individual’s recurring order and sends that order to the correct customer care representative to handle at the proper time.
One of the significant challenges for a medical supply provider is making certain that the correct physician prescription documentation required to compliantly ship the specific supplies requested has been collected. To answer this challenge, HCD created a system called MediDocPro® that manages the tracking of these documents from creation to resolution.
This system integrates with USS to detect when medical documentation is requested. MediDocPro® then creates the proper document based on the payor, condition and products requested in an order. Once created, the document is automatically faxed to the physician and then tracked through a workflow system until the document is returned. Once the document is returned MediDocPro® notifies USS and OrderPro®, our proprietary order management system, and stores an image of the document in our document imaging system.
HCD’s proprietary Formulary Management system allows us to easily manage and compare the thousands of products available to HCD for our customer population. By automating the process of comparing insurance plan coverage and quantity limits, HCD can build the best possible product set for the applicable disease state and/or condition, thereby contributing to improved clinical outcomes and enhancing customer satisfaction.
The system also allows for greatly increased efficiency (e.g., before Formulary Manager was implemented, it would take on average two weeks to build and load a formulary; today that same activity takes two days).
As our patient population grows in more areas of the country, HCD is able to ship the products to those patients as quickly and economically as possible. We work with several distribution partners, and run our own distribution center as well, to service the different product categories and geographic areas of the country.
To enable this we have built out a proprietary Distribution Management system that connects directly to our OrderPro® system to ensure that we send a patient order to the correct distributer based on cost, condition and the location of the patient. Changes to the distribution model can be made by our product specialists as new distributors come online or change their prices and/or product mix.