Self insurers have multiple options when it comes to arranging medical equipment for injured workers. They can source the equipment directly from medical equipment stores, tap into the network of an ancillary services provider or purchase from an online vendor.
The latter is becoming increasingly common as selling merchandise on the Internet becomes easier. And it's no wonder, as the global market for home medical equipment in 2009 was about $16.8 billion and is projected to grow to $23.8 billion by 2015 1.
As more vendors sell medical equipment online, self-insurers are using the Internet as a resource to find bargains. But sourcing equipment online brings risks and can frequently cost self-insurers more over the long term. Whether an organization is currently purchasing equipment online or is evaluating such a strategy, it is essential to consider the following points.
Is the online medical equipment vendor licensed and accredited?
When purchasing medical equipment online, verify that the vendor is licensed and has a reputation for providing quality service. This will ensure the injured worker receives the medical equipment they need in a timely manner. There are a few ways to determine if a vendor is accredited.
Check to see if the vendor is a licensed provider in the state their business operates. This can be done by conducting a public records search for business licenses like this site to find where to access a business license database per state2.
Also, research if the vendor is an accredited medical equipment provider with the Better Business Bureau (BBB). This can be done by calling the BBB at 703.276.0100 or visiting the BBB website. The BBB accredits and then rates vendors based on a specific set of criteria such as duration of operation, obtaining required licenses and evaluating service complaints 3.
Does the online medical equipment provider set up equipment, offer training or provide fittings?
Self insurers are faced with the challenge of providing injured workers quality care while managing claim costs. While finding a discounted piece of equipment online may seem like the best solution because of price, consider the bigger picture. It's about more than just the price for equipment; it's also about ensuring injured worker safety.
Medical equipment that is set up incorrectly or injured workers who are not trained on its proper use can lead to re-injury, delaying their recovery and ultimately their return to work. Therefore, when purchasing medical equipment online, it is important to determine if the vendor will set it up upon delivery and arrange for proper fittings.
Another critical consideration when evaluating medical equipment vendors is to determine if they will provide the injured worker comprehensive education on equipment use.
What is the online medical equipment vendor's policy for replacing malfunctioning equipment?
Even the highest quality medical equipment can break or malfunction. That is why it is essential to closely review an online medical equipment vendor's policy for replacing defective medical equipment. In many cases, it will be the responsibility of the injured worker to contact the vendor directly to resolve the issue or return the equipment for a replacement.
If an injured worker attempts to replace defective medical equipment and is not receiving quality service from the original vendor, they may take matters into their own hands. This can lead to out-of-network bills - meaning higher claim expenses and more paperwork.
Does the online medical equipment vendor automatically ship equipment?
With fraud statistics remaining high, a medical equipment vendor should not automatically ship equipment to the injured worker without prior authorization. This ensures the appropriate equipment is ordered, duplicate equipment is not shipped and the injured worker receives the best available medical equipment for the nature of the injury.
By eliminating unauthorized medical equipment shipments, self-insurers can reduce medical equipment expenses - which comprise 9 percent of a workers' compensation medical claim 4.
Can online medical equipment vendors simplify the coordination of care?
Making all of the necessary contacts to coordinate a claim can be very time consuming for self insurers. Online medical equipment vendors typically only offer equipment. This could mean multiple phone calls and hassles for self insurers.
To simplify the coordination of care, consider using an ancillary service provider that can make arrangements for home health care, transportation, language services, diagnostics, physical medicine and catastrophic care needs.
Ancillary Service Providers
Working with an ancillary service provider can alleviate the concerns faced when ordering medical equipment online. This working relationship can save self insurers time and effort, creating peace of mind. An ancillary service provider can remove the hassle when ensuring a vendor is legitimate and has a solid reputation for offering quality medical equipment.
Ancillary service providers work with a network of safe and dependable vendors that offer equipment at discounted rates, which eliminates the hassle and time involved in evaluating vendors. Self insurers should look for a partner that ranks its medical equipment vendors on stringent criteria such as customer service, geography, proper licensure and credentials, compliance with state and federal laws, quality management and contract adherence.
The ranking system should also provide the injured worker with on-time delivery, exceptional service, training as needed and fully operative equipment. These ranking systems will ensure that the injured worker receives the best care available at the most cost-effective price.
Partnering with an ancillary service provider can also help manage concerns around medical equipment set up and maintenance. A provider should have the capability to fully coordinate services between the equipment vendor, injured worker and claims professional. This means they will arrange all orders, delivery and necessary fittings.
The ancillary services provider should offer complimentary equipment set up at time of delivery as well as provide the injured worker with comprehensive training on proper usage. Additionally, ancillary service providers will follow-up with the injured worker as needed to ensure the medical equipment is working properly and that there are no questions on how to use it correctly.
In the event a malfunction occurs within warranty guidelines, most ancillary service providers will immediately resolve the issue. This means the injured worker will not have to coordinate the return or wait a long time for a replacement to arrive.
Eliminating the chance of injured workers going out-of-network to fix their medical equipment also reduces the pains felt by self insurers.
Conclusion
Many options are available in selecting a medical equipment provider, so how does a self insurer know which vendor will offer the most cost-effective, quality product and service? To ensure the best business partnership, critically evaluate a provider's legitimacy, reputation, defective equipment policies and customer service. To simplify the coordination of care, a self insurer may determine that saving a few dollars with online bargains is not worth risking injured worker safety or satisfaction.
References:
1. BCC Research. Home Medical Equipment: Technologies and Global Markets. May 2010. http://bccresearch.com/report/home-medical-equipment-hlc054b.html.
2. Public Records Directory. http://publicrecords.onlinesearches.com.
3. Better Business Bureau. http://www.bbb.org/us/.
4. Lipton B., Cooper G. and Robertson J. NCCI Research Brief. Medical Services by Size of Claim. Winter 2009.
About the Author
Tron Emptage is chief clinical officer at Progressive Medical, Inc., which helps payors achieve better outcomes for injured workers and more control over expenses through a powerful combination of network capture and conversion programs and clinical expertise. He can be reached at Tron. Emptage@progressive-medical.com or 800.777.3574.
