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Reimbursement

Management Company Insights: Reimbursement-Related Services

October 2018

As part of our reimbursement-focused edition, Today’s Wound Clinic recently surveyed management company representatives about their expectations and roles with reimbursement-related services for outpatient wound care clinics. Their responses are shared here. 

When contemplating the opening of an outpatient wound care and/or hyperbaric oxygen therapy (HBOT) provider-based department (PBD), many hospital administrators tend to ask, “Should we develop and operate the PBD ourselves or should we contract with a management company that specializes in the services we wish to offer?” If the decision is that a management company is the best option, the hospital’s executives should clearly discuss the services that they need from a management company and how those services must assimilate into the hospital’s processes. These executives and any wound care/HBOT stakeholders should also interview potential management companies to determine who offers the services that best meet the predetermined needs and processes. A discussion that clearly delineates the roles of the hospital’s staff and the management company in the operation of the PBD is also essential. The goal of the survey that produced the results found in this article (see Table at right) was to learn how reimbursement-related services may be performed differently among management companies and which reimbursement-related services the hospital and PBD must generally perform. Four management companies participated in this research effort, and as readers will learn here, each company offers a slightly varied menu of reimbursement-related services and operationalizes those services in varied ways. These responses should give PBD executives and stakeholders a better idea of how to discuss needed services with potential management partners. Remember, there is no “correct” or “incorrect” method. All PBDs have different needs in the lifecycle of their wound care and/or HBOT programs. (Note: responses were edited for space considerations.)

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