Managing DME program compliance from overarching CMS complexity to specific guidelines from local insurance plans.
Working with Breg Impact to stay on top of billing requirements.
OIP’s DME program has generated $2.5 million annually in ancillary revenue. Their success is driven in large part due to a long-standing partnership with Breg Impact consulting who provides compliance guidance, and the use of Breg
Vision which enables paperless transfer of billing information for clean claims.
- Minimal business disruption by getting out in front of changing federal and local compliance requirements
- Faster payment of claims due to easy and complete documentation of patient DME dispensement
- Invaluable time saved by eliminating insurance denials due to incomplete claims
Orthopedic Institute of PA provides care to approximately 15,000 patients in central Pennsylvania each month. The orthopedic group has 11 physician office locations, three orthopedic injury clinics and smaller facilities in outlying areas to serve rural populations. Orthopedic Institute of PA also cares for local high school teams and recreational leagues, and the Arlington division provides team physicians for the Harrisburg City Islanders professional soccer team.
Founded in 1970 by three physicians as Orthopedic Surgeons, Ltd, the practice expanded through mergers and acquisitions to include 38 physicians across multiple locations. Now known as the Orthopedic Institute of Pennsylvania, Family of Care, the group practice encompasses two divisions – OIP and The Arlington Group. They offer three walk-in injury clinics where patients can receive immediate care for urgent orthopedic issues. The Orthopedic Injury Clinic model helps reduce costs by enabling patients to avoid a more expensive visit to an emergency room at a hospital. The Orthopedic Injury Clinic provides a better patient experience with typically lower wait times to see a provider for orthopedic injuries like strains, sprains, fractures and dislocations.
“OIP was the first to offer orthopedic injury clinics which definitely set us apart as an orthopedic provider,” said Julia Nevil, DME program coordinator for OIP. “Another differentiator is our ‘give back’ philosophy.” OIP created the OIP Foundation to promote healthy living in South Central Pennsylvania and mobilize medical expertise and resources globally. Foundation grants support health education projects, provide access to preventative health care and fund medical missions to developing countries and international locations in crisis.
“The support I get from my Breg sales rep and Breg Impact consultants is my saving grace. Their unlimited knowledge around staff education, product selection, how to navigate the complexity of CMS and local compliance, and their assistance with technological transitions has kept me grounded and headed in the right direction within my company.”
Julia Nevil, LPN, CPC, CPC-P, CPMA
DME Program Coordinator
OIP began offering Durable Medical Equipment (DME) direct to patients in 2007, with the Breg Impact consulting program to help them set up a compliant program. They also implemented Vision Patient Workflow Management software for inventory oversight. OIP moved to the mobile platform a few years later, enabling anytime, anywhere DME dispensement. OIP was a beta test site to integrate Breg Vision with their EHR/EMR practice management systems, which provide for the exchange of patient DME information. The group practice integrated Breg Vision in July 2014, which significantly improved the practice’s clean claims.
“One of the best things about Breg Vision is how it has improved our billing efficiency and reduced payment lags,” said Julia. “It provides everything I need for a clean claim: detailed written orders, physician signatures, proof of delivery, product information…it’s all right there for insurance billing. Before Breg Vision was integrated, it was all paper—paper is awful—you can’t read the handwriting, information is left off and paperwork goes missing. Insurance companies constantly pushed back because of gaps in information. Now with Breg Vision integrated, there are rarely any questions or delays. We’re paid right away. It has virtually eliminated all the back and forth with insurance providers.” Julia said she can’t even estimate how much time she has saved as a result.
“We’ve been with Breg a long time, and there is a reason,” Julia added. “A decade ago, the Breg Impact team helped us establish a solid foundation for our DME program, which has allowed me to expand and develop it without any compliance worries. They understand my business and have helped me work through changing requirements at the federal and local level. I don’t know how other groups do it without them.”