<img style="float: right;" src="https://opedge.com/Content/OldArticles/images/2003-10_10/Sansone-Joe.jpg" hspace="4" vspace="4" /> <b><i>With Medicare threatening to cut reimbursements yet again and new competitors gobbling up market share, O&P facilities are now forced to analyze their businesses and seek opportunities to increase their referrals. Many companies may feel they must join competitors in accepting lower reimbursement rates, just for the privilege of being on a managed care plan. Rather than taking the easy way out by negotiating contracts with lower margins in a futile attempt to stay afloat, you can enlist other options to increase your practice's profitability.</i></b> <h1>The Road Less Traveled</h1> If accepting lower reimbursements from additional managed care plans is not the path you choose, another option is to increase the number of referrals you receive. Although difficult, increasing your level of services is a tried-and-true method to increase revenue. Here are some ways to increase your level of services: <b>On-Call:</b> Although one of the most controversial issues in the O&P industry, on-call service is one of the most effective ways of increasing referrals. How on-call requests are handled in the O&P industry varies dramatically throughout the country. While speaking to large groups of practitioners and asking for a show of hands of those who routinely provide after-hours on-call service, I have seen as many as 80 percent or as few as 5 percent of the practitioners raise their hands. Providing customers with 24-hour service seven days a week offers a unique opportunity to differentiate your facility from competitors. Have you ever received a call from a panicked case manager at a hospital asking how quickly you can make and deliver a TLSO, because the hospital has been waiting three days for another provider to supply the brace? These types of calls are an obvious cry for help--and a salesman's dream come true. An alert practitioner will turn this request into an opportunity to impress an account and garner future business. If a company markets its 24/7 services to case managers and nursing personnel on the floor, it will eventually be called. Many O&P providers have been successful in securing long-term contracts by offering these services. The scenario is usually as follows: even though they are not directly contracted, a hospital has been using one O&P facility, with a relatively slow turnaround time, exclusively for several years. A new company enters the market and solicits the hospital's business, offering unsurpassed on-call service. Even though nurses and case managers are familiar with the slower turnaround time of the current provider, they still remain loyal. <img style="float: right;" src="https://opedge.com/Content/OldArticles/images/2003-10_10/Business-People-101.jpg" hspace="4" vspace="4" /> An emergency arises; the old company can't provide the product in time, so the new company is called. The new company delivers the product quickly, leaving the hospital staff visibly impressed. After several similar instances, the nursing staff realizes that the new company is more responsive, and the newer company not only receives STAT orders but soon receives all bracing orders. <b>Turnaround Time:</b> If an urgent call at 8:00 PM is for a custom TLSO, it does not serve the customer or patient if the practitioner casts for the brace, then drops the cast off at the fabrication shop the next morning to be completed that afternoon. When addressing turnaround time, companies that provide their own fabrication have a distinct advantage over facilities that use central fabrication. <b>A select few O&P facilities, besides having an orthotist on-call</b>, also have a fabrication technician on-call. When the practice receives a call at 8:00 PM for a custom-molded TLSO, the orthosis is on the patient by 8:00 AM when the physician makes his rounds the next morning. Such turnaround time will not only win the O&P provider the allegiance of the hospital, but also the loyalty of referring physicians. I recall when we fit a patient with a non-urgent brace in a hospital on Easter Sunday. I was bursting with pride when the physician commented on how impressed he was with our turnaround time. He had never before experienced such service with other companies and pronounced his undying loyalty. When an orthopedic surgeon learns that upon sending a patient to your facility, you are able to pre-cert immediately, cast or measure his patient for a brace, and then automatically schedule a return visit quickly, you are more likely to become his provider of choice. When my sales representatives provide an inservice to a facility or a managed care entity, they offer a challenge: send us a custom-molded TLSO, and we will turn it around in less than four hours. We have the largest staff of practitioners and the largest fabrication department in town. We dare the referral source to call us for an emergency order, because we know that we will come through for them. <b>House Calls:</b> Making house calls is probably the most unreasonable request that practitioners receive. However, providing this service clearly differentiates you from your competitor. When our O&P company first started out, it was a promise to make house calls as required that enabled us to get noticed. Later, these relationships allowed us to become a preferred provider for the referral sources. <b>Managed Care Issues:</b> In what ways do you work with managed care entities? Are you the provider that case managers call when they face a difficult situation or dissatisfied patient? Offer this level of service to your payers, and you may become the first person they call. <b>Inservices:</b> Do you know medical professionals who would benefit from specific education in O&P products and services? Inservices provide a valuable service for your customers by expanding their knowledge--and they go a long way towards gaining future referrals. <b>Physician Service:</b> The service that physicians receive from O&P providers is not to be overlooked. How often do your physicians or referral sources see a representative from your company? I often consult with practices whose largest referring physicians rarely see a representative from their O&P provider. If there is a vague or ambiguous prescription, how quickly does the physician receive a follow-up call? Are your practitioners available for consult whenever a physician calls, or is the physician forced to wait until a practitioner can call at a later time? Does the physician's staff have a relationship with someone from your company, so that they can address any issues that may arise? Build this sort of relationship with your physician's office to retain your hard-earned business. <h1>Making the Most of Your Service Levels</h1> It is very important to ensure that the additional services you provide are not wasted. Are your physicians and customers aware via marketing efforts of the levels of service that you are willing to provide? Keep in mind, <b>providing the best service in your market is absolutely useless from a business perspective if a physician does not know what you are doing for him and his patients.</b> I have seen companies lose accounts because other practitioners have walked in the door and promised levels of service that very much impressed the physician. It was too late then to point out to this physician that the current provider had been providing the same levels of service for the past several years. Your company's practitioners also must focus on high-level customer service and be ready to provide it. I remember interviewing a highly qualified practitioner who actually yelled at me when I described the level of service our company provides and requires from our practitioners. He said we would be doomed to hiring only mediocre performers by requiring this service level. Surprising--or maybe not so surprisingly--he was looking for a job because he was closing his doors due to a lack of business. As stated earlier, it is much easier to attempt to find simple, easy fixes to increase referrals. However, the more difficult strategies will often bring the greatest amount of referrals. Do not take the easy way out. Service your customers and your patients--and you will be able to increase your business while providing unsurpassed patient care. <i>Joe Sansone is CEO of TMC Orthopedic, Houston, Texas.</i>
