Laugh and the world laughs with you. snore and you sleep alone.

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Presentation transcript:

Laugh and the world laughs with you. snore and you sleep alone.

Integrating DME Into Your Sleep Practice FOCUS FALL 2013 Mirsa K Nieland, R.EEG.T.

The Factors Forcing Change: Increase in OCST (Out of Center Testing)  Insurance Provider Requirements In the past few months several large insurance companies have changed their requirements for reimbursement.

The Factors Forcing Change: Decrease in Reimbursements In center testing reimbursements have decreased as much as $350 per study in our area. With average allowable fees falling into the $600 range, many sleep centers simply cannot afford to operate as they have in the past.

The Factors Forcing Change: Physicians shifting from private practices to joint ventures Many physicians feel that the decrease in reimbursements and the increase in Medicare patients have forced them to make drastic changes in their business models.

The Factors Forcing Change: The Internet The internet has expanded the ability of patients to self diagnose (ie. Purchasing home testing kits online).

The Factors Forcing Change: Advances in Medical Technology With the introduction of Provent and the increase in oral appliance options, many patients are trying to avoid the need for sleep studies all together.

Is DME the Answer?? Staying competitive Given the changes our industry has experienced in the past couple of years, the need to change our business models is no longer just a distant thought, it is a reality.

Is DME the Answer?? Review your current contracts The first and most important step in moving forward with DME, is to make sure you will be able to get paid for it (ie. contracted CPT codes).

Is DME the Answer?? Understanding Lease/Purchase The current trend in reimbursement for DME is lease/purchase. Your cash flow will change as well as the time commitment to each patient.

Is DME the Answer?? Follow-up, Follow-up, Follow-up….. Continuous patient flow is paramount in succeeding with DME. Retaining your current patients will increase your revenue, the key is to establish a solid follow-up plan.

Is DME the Answer?? Staffing, Scheduling & Billing… Your new DME Department will require a lot time and coordination between Technical, Billing & Scheduling/Office staff. A lack of efficient communication between any one of these departments can quickly turn DME into a money loosing proposition for your center.

Questions ??? Contact Information: Mirsa K. Nieland R.EEG.T.