SUMMARY
OF SERVICES
WHAT’S INSIDE 03 FOUNDER’S STORY 04 SERVICE CENTRIC MODEL 06 WHAT TO EXPECT FROM HOMELINK 08 DME/O&P/SUPPLIES 10 COMPLEX REHAB TECHNOLOGY 12 HOME HEALTH/INFUSION 14 TRANSPORTATION/LANGUAGE SERVICES 16 HEARING HEALTH CARE 18 HOME AND VEHICLE MODIFICATIONS 20 PHYSICAL MEDICINE 22 POST-ACUTE CARE 23 DIAGNOSTIC IMAGING 24 HOME SLEEP TESTING 25 DENTAL CARE 26 HOMELINK INDEX OF SERVICES
2 | HOMELINK | Summary of Services
FOUNDER’S STORY
Est. 1993 HOMELINK began as an idea. An idea in the mind of a visionary with a simple philosophy: provide outstanding home health care services for people to recover and experience a higher quality of life. Founder Van G. Miller understood that community-based HME providers, while often overlooked in the health care industry, were key to achieving this vision. In 1986, Van developed a solution to help communitybased providers compete with the larger, national HME providers. He created a buying group – The VGM Group – devoted to providing access to key manufacturers and discount prices for independent businesses in the HME industry. With the same spirit investors showed him, Van entrusted Dave Kazynski to bring one of his entrepreneurial ideas to life. Thus began HOMELINK in 1993. Dave partnered with Brent Hanson to begin HOMELINK. Serving as president and senior vice president, respectively, Dave and Brent were armed with
a couple phones, a few sheets of paper, and roughlydrawn network coverage maps. They painstakingly spread the word that HOMELINK was the connector between quality providers and payers. More than 25 years later, HOMELINK has grown into the #1-rated entity in the industry, with a 99.6% customer satisfaction rating and a Net Promoter Score of 70.4. HOMELINK’s 500+ employee owners connect over 1,200 payers. These payers are connected to more than 36,000 core providers and an additional 72,000 community-based providers in our database, giving the highest quality of care to more than 30 million covered lives. Today, the HOMELINK story is stronger than ever thanks to a commitment to providing unparalleled customer service and unsurpassed value to its loyal customers.
HOMELINK | Summary of Services | 3
SERVICE CENTRIC MODEL CUSTOMER EXPERIENCE Our business is built on uncompromised service. Each and every HOMELINK associate takes ownership of their work and interactions with those they serve. While other companies utilize offshore customer service functions, HOMELINK believes every call should be answered personally by an associate with dedicated training and industry knowledge located here at our home office. We measure our service with a process called Net Promoter Scoring (NPS). Our overall NPS is 70.4, approximately a 4 times more positive experience than health care industry benchmarks. HOMELINK’s clients have experiences comparable to when they interact with brands such as Apple, Amazon, and Netflix. 4 | HOMELINK | Summary of Services
NPS isn’t just marketing spin — it is truly part of HOMELINK’s culture. Research shows positive patient experiences have a significant correlation to faster return to work, decreased litigation, and reduction in downstream consequences.* It’s a fairly obvious outcome, but service that drives experience is typically the first thing companies cut to optimize their financials. Since 1993, we have put our focus and investments into process refinement, service, and creation of positive experiences — leading us to a 99.7% client retention rate.
*Andrews, L., Cordina, J., & Kumar, R. (2016). Great Customer Experience: A Win-win for Consumers and Health Insurers. Retrieved from https://healthcare.mckinsey.com/sites/default/files/Great_customer_experience.pdf
You can be certain you will receive only the best from HOMELINK. This is our commitment to you. CONTAINMENT PROCESS
NETWORK Our national provider network is unique to say the least. We focus on building relationships with community-based providers along with national providers and manufacturers. All network providers undergo a strict credentialing process and are monitored by our Quality Assurance team that follows URAC and NCQA guidelines, leaving you access to only the highest quality providers.
We believe cost containment is the product of great processes. Without processes that manage utilization, complete savings will never be realized. Price is not the sole metric. It is with this understanding that we design our workflows so utilization is managed and maximum savings are achieved.
SOFTWARE All our solutions are facilitated under a single platform. Our system creates flexibility and allows processes to be customized to your needs while maintaining operational consistency, something that is crucial in the overall HOMELINK experience. Business intelligence capabilities provide you a suite of interactive reports, showcasing savings, utilization, and trends.
NETWORK
CUSTOMER EXPERIENCE CONTAINMENT PROCESS
SOFTWARE
HOMELINK | Summary of Services | 5
WHAT TO EXPECT FROM HOMELINK ORGANIZATIONAL STABILITY & INDUSTRY-LEADING PRICING
| Summary | Summary 66| |HOMELINK of Services HOMELINK of Services
TIMELY AND ACCURATE FOLLOW-UP
ASSOCIATES EAGER TO LISTEN AND UNDERSTAND YOUR NEEDS
KNOWLEDGEABLE ASSOCIATES PASSIONATE ABOUT CARE
SOLUTIONS, NOT EXCUSES
NPS AND WHY YOU SHOULD CARE Net Promoter Score (NPS) is more than just another acronym and a bunch of numbers. At its core, NPS is a loyalty metric that helps businesses determine how people feel about them.
IT’S REALLY ABOUT EXPERIENCE If you ask our company to pick one thing we value above all else, we say experience. At HOMELINK, fostering positive experience is ingrained in our culture. We connect patients, payers, and providers, so those relationships are important to thousands of individuals. The way we’re implementing NPS tracking is about so much more than just seeing how people feel about us — it pulls our culture directly into our operations.
IT DOES MORE THAN YOU THINK If all NPS did was help us cultivate relationships, that honestly would be enough. But, the effect of having a real-time experience metric is diagnosing a more serious problem long before you’d historically figure it out. Because our NPS is tracked in real time, we can detect when issues arise more quickly than we would have in the past.
COMPARED TO A HEALTH CARE INDUSTRY AVERAGE NPS OF 17, IT’S NO QUESTION THAT HOMELINK STANDS OUT AS THE BEST. 0
-50
64.6 2020
-100
100
50
OVERALL
NPS
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DME / O&P / SUPPLIES
With firmly planted roots in the durable medical equipment (DME) industry and powered by relationships with over 17,800 providers and manufacturers, HOMELINK is without question the leader in DME/O&P/Supplies. With the help of experts who are intimately involved in every aspect of the industry from regulation to equipment manufacturing, you will not find another provider network as insightful as HOMELINK.
HOMELINK’S REVIEW PROCESS PROVIDES COST CONTAINMENT SOLUTIONS FOR:
MANUAL & POWER WHEELCHAIRS
PNEUMATIC COMPRESSION DEVICES
BONE GROWTH STIMULATORS
ELECTROMEDICAL
99.84%
48 hours
Referrals Prospectively Staffed
Average Staffing
8 | HOMELINK | Summary of Services
MEDICAL SUPPLIES
PROSTHETICS
51.30% Average Savings
A CLOSER LOOK AT PROCESSES PROSTHETIC REVIEW The purpose of the HOMELINK prosthetic management process is to ensure medical appropriateness and management of medical expenses associated with the dispensing of prosthetic devices. Our prosthetic patient care coordinators (PCCs) work hand-in-hand with our clinical review team and staff prosthetists. Each prosthetic device ordered is assessed and evaluated to confirm the patient receives the device they need and no unnecessary additions are included.
Claims with the following characteristics qualify for review: • Myoelectric upper extremity prosthetics
• Excessive socket changes
• System upgrades to microprocessors
• Replacement prior to 2 years
• Excessive utilization of miscellaneous codes
MISCELLANEOUS CODE MANAGEMENT A dedicated team reviews all miscellaneous codes for proper usage, establishing a clear picture of utilization is obtained. The result for one client:
REAUTHORIZATION
Reduction of
Focuses on patient compliance with rental equipment and supplies through a defined follow-up workflow monitoring utilization. If a patient is no longer using the equipment or supplies, HOMELINK notifies the claims professional and establishes next steps.
in spending.
One client’s savings:
$562,500
$637,998
RENT-TO-PURCHASE By exercising strict business rules, our rent-to-purchase program spots costly overbilling once the purchase price of a product has been met by the cumulative rental payments.
$
Client realized
1,700,000 in savings.
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COMPLEX REHAB TECHNOLOGY Utilizing a network of local on-staff Assistive Technology Professional (ATP) licensed providers, our team excels at recommending medically appropriate and individually configured mobility equipment across the country. HOMELINK’s Care Continuum specializes in comprehensive monitoring of cases following a patient’s progress as they return home. With the help of the Functional Mobility Assessment (FMA) and staff ATP, our network of specialty providers shows outcomes superior to their peers.
78% increase in patient satisfaction
64% decrease in reported falls
82%
reduction in readmissions due to seating mobility incidents
52% decrease in skin breakdown
Complex Rehab Technology (CRT) requires a dedicated team to identify the most medically necessary and cost-effective equipment to promote quality of life.
SERVICES INCLUDE 10 | HOMELINK | Summary of Services
• Complex powerchair systems • Highly configured manual wheelchairs • Adaptive seating
• Alternative seating systems • Equipment repairs • Other specialized mobility devices
Issues are handled IMMEDIATELY with resolution implemented within
AN AVERAGE OF
42 MINUTES HOMELINK HOMELINK| |Summary SummaryofofServices Services || 11
HOME HEALTH HOMELINK’s nationwide network of home health providers covers the many needs of patients in the home. From nursing, in-home therapies, and IV services to medical supplies and pharmacy services, our patient care coordinators ensure medical treatment is functionally based and medically necessary. Backed by a clinical team of licensed nursing professionals, HOMELINK’s processes are designed to control overutilization, procurement, and billing integrity — all designed to provide you low cost. HOMELINK’s Clinical Review Process provides the most appropriate care to the patient in the most efficient manner while reducing cost. This is accomplished through proactive review of the patient’s needs conducted by seasoned, licensed nursing professionals. Clinical oversight begins the moment of referral intake and moves through the continuum of cares.
It is a priority for HOMELINK to continuously engage and review home health claims to ensure appropriate, cost-effective care. 12 | HOMELINK | Summary of Services
Patient’s acuity level determines the frequency of step-down evaluations, review of patient notes, and comprehensive evaluations by their assigned Clinical Review nurse.
Level
1
Patients requiring the highest level of detailed action.
Level
2
Patients requiring continuous evaluation. Typically individuals have completed rehabilitation and are moving into stabilized living.
Level
3
Patients requiring periodic evaluation. Patients are in a home setting.
Level
4
Patients with ongoing care needs that cannot be lowered due to maximized efficiencies or other circumstances. May include patients with ongoing complex care needs.
CATASTROPHIC CARE Our clinical team specializes in the intricacies of catastrophic care, starting with a dedicated associate as your single point of contact to coordinate the care for these multi-dimensional claims. With over 25 unique touchpoints fostering trust and clarity, our clinically-based processes are built on providing compassionate care and specialized expertise to your patients.
HOMELINK made recommendations to a client in care of nine catastrophic cases, which resulted in
$533,729
HOME INFUSION Utilizing clinically-designed procedures covering the broad scope of infusion therapies, our focus is to ensure patients remain compliant, desired outcomes are reached, and costs are contained.
Access to: 13,000+ infusion products 250+ specialty providers 9,700+ network providers
in reduced spending. HOMELINK | Summary of Services | 13
TRANSPORTATION/LANGUAGE HOMELINK’s Transportation Program centers around a proven philosophy of high-touch workflows. These workflows ensure you receive friendly, efficient, and affordable service when HOMELINK coordinates your patients’ logistic needs.
CONTROLLED ACCESS
REDUCED FRICTION
Controlling the access points and scheduling through HOMELINK reduces aberrant events and improves patient experience, limiting variabilities and increasing compliance.
The only rule in workers’ compensation is everything is an exception. Our pre-trip assessments pair patients with the best mode of transportation. A simple process that makes sure your patient’s trip starts off right.
ACTIVE MONITORING We monitor trips and reschedule/switch drivers when circumstances require. After each trip, we contact the patient and make sure everything was to their satisfaction.
TRANSPORTATION Sedan
Wheelchair
Stretcher
Advanced Life Support
Air Ambulance
TRAVEL COORDINATION SERVICES Commercial Air 14 | HOMELINK | Summary of Services
Rail and Ground Transportation
Hotel Accommodations
Medical Professional Escorts
RIDESHARE SAVINGS Over Traditional Transportation
San Francisco 37% Los Angeles 29% Chicago 24% Philadelphia 20%
RIDESHARE DELIVERS FOR YOU Driven by rideshare companies such as Lyft and powered by a proprietary interface, HOMELINK seamlessly qualifies patients through an initial assessment process, ensuring fit and proper authorizations. Rideshare trips can be staffed at a moment’s notice or scheduled in advance.
Needs Assessment
Real-Time Management
Patient Notifications
No Wait Time
HOMELINK’S LANGUAGE PROGRAM On-site and telephonic interpretation services include coverage of medical appointments and certified interpreters for legal mediations and court hearings.
Language Services
Document Translation
• Hundreds of languages, including American Sign Language
• Medical and legal documents
• Transcription services • Certified legal and medical interpreters
• Correspondence • Video interpreting
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HEARING HEALTH CARE HOMELINK’s Hearing Health Care brings clinical expertise and oversight to hearing claims, ensuring medical necessity is met, not exceeded. With over 5,000 providers across the country, HOMELINK’s Hearing Health Care offers you one of the most extensive networks and the strongest savings in the industry.
COST CONTAINMENT STRATEGIES
AUDIOLOGICAL REVIEW PROCESS
HOMELINK simultaneously provides the proper device to the patient and cost savings to the payer.
REPAIR VS. REPLACE
FDA requires that hearing aid manufacturers repair all hearing aids with original parts for at least five years, eliminating the fictitious need to replace hearing aids every three years.
VALUE BUNDLE PRICING
Your price includes the cost of hearing aids, one year of provider services, ear molds, a three-year warranty program, and five years of batteries.
OVERSIGHT
A dedicated patient care coordinator follows your patient through all levels of care, supporting the patient from beginning to end.
16 | HOMELINK | Summary of Services
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SAVINGS
$2,200
PER ORDER
$11,000
PER LIFETIME
SAVINGS
STANDARD 3-YEAR REPAIR WARRANTY
5 YEAR BATTERY SUPPLY PROGRAM
TOTAL PATIENT SUPPORT
HOMELINK HOMELINK| |Summary SummaryofofServices Services || 17
{
COST CONTAINMENT IS THE BYPRODUCT OF GREAT PROCESSES. HAVING A PARTNER WHO CAN MANAGE THE PROJECT AND KEEP IT ON TIME AND BUDGET IS KEY.
HOME AND VEHICLE MODIFICATIONS
}
Over
1,200
providers located across the nation making sure your needs are covered whether you are in Sheboygan, WI or Los Angeles, CA.
18 | HOMELINK | Summary of Services
Supported by a team of Certified Environmental Access Consultants (C.E.A.C.), HOMELINK Accessibility Modifications specializes in the coordination of home, vehicle, and workplace modification. This means you will receive a level of professionalism and knowledge found only at HOMELINK. With over 1,200 providers located across the nation, HOMELINK’s network of contractors makes our Home Modification division THE NATION’S LARGEST PROVIDER OF ANCILLARY HEALTH CARE SERVICES to hundreds of workers’ compensation, auto, group health, and FEHBA clients.
HOMELINK’S PILLARS OF MODIFICATION EXCELLENCE SCOPE
• • •
Coordinate OTs, contractors, architects, and engineers for evaluations Utilize experts on ADA standards and requirements Develop scope of work based on medical necessity and what is reasonably required
PRICING
• • •
Secure direct pricing from manufacturers More than 1,200 credentialed providers Provide cost estimates that are reasonable, necessary, and appropriate
TIMELINESS
• • •
Standardized estimates for pricing continuity and accuracy Project oversight and frequent updates to prevent costly delays 24-hour access to patient care coordinators
OVERSIGHT
• • •
Clinical oversight to ensure medical necessity Employ C.E.A.C. specialists Submit supporting documentation with corresponding photos
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PHYSICAL MEDICINE HOMELINK Physical Medicine provides you access to a national network of premier outpatient rehabilitation providers. Our network focuses on individualized and evidence-based treatment protocols, promoting a safe, timely, and cost-effective return to work and previous level of functioning.
WHAT YOU GET FROM HOMELINK PHYSICAL MEDICINE INITIAL REPORTS WITHIN 24 HOURS REGULAR STATUS UPDATES ESTIMATED DISCHARGE DATE AND NUMBER OF ANTICIPATED VISITS
prospectively staff
99.8 20 | HOMELINK | Summary of Services
of referrals
Studies show physical therapy at the beginning of care results in
LOWER COSTS and the reduced use of health care resources.*
THREE STEPS TO QUICKER RECOVERY
1
2
3
Treatment recommendations based on professional practice guidelines, utilizing an innovative outcomes program by CareConnections. These recommendations are provided to the claims professional for approval.
Experienced therapists work closely with providers throughout the rehabilitation process to ensure treatment is functionally based and medically necessary. Peer reviewers monitor ongoing functional progress, pain reports and fear-avoidance behaviors.
Patient non-compliance with the treatment is promptly reported to the claims professional. Outcomes are consistently monitored to ensure providers exceed industry standards.
* Implications of early and guideline adherent physical therapy for low back pain on utilization and cost, Childs et. al., BMC Health Services Research (2015)
HOMELINK | Summary of Services | 21
POST-ACUTE CARE POWERED BY ADVA-NET HIGH-TOUCH CARE COORDINATION AND EXPERT LEVEL OF CARE Each patient’s unique needs are matched to the specific capabilities of the facility.
CLEAR FOCUS Comprehensive operations and clinical teams focused on patient-centered care. • • • • •
Registered nurses with advanced certification in long-term care Board certified physician Licensed/registered physical therapist Health care billing/coding revenue cycle administrator Certified recreational therapist
COORDINATED DISCHARGE PROCESS Interactive collaboration with Adva-Net’s care teams and HOMELINK’s clinical staff makes the transition to home care a smooth process.
HOMELINK’s post-acute care (PAC) services encompass more than 5,200 post-acute care providers. Unique to our PAC solution is the structural role of interdisciplinary clinical and administrative teams, resulting in deeper savings and clinical oversight specific to the needs of the patient.
LONG-TERM CARE (LTC) I INPATIENT REHAB I SKILLED NURSING FACILITIES COORDINATED DISCHARGE PROGRAM I CLAIM ANALYSIS 22 | HOMELINK | Summary of Services
DIAGNOSTIC IMAGING HOMELINK Diagnostic Imaging expedites quality treatment, enabling prompt diagnosis and reduced disability duration. Using fundamentals found within value-based medicine, HOMELINK provides your patients high-quality, coordinated, and efficient care.
SUCCESSFUL OUTCOMES START WITH EFFECTIVE DIAGNOSTIC IMAGING
ADVANCED IMAGING (MRI, CT & PET)
ELECTRO DIAGNOSTICS (EMG, NCS & EEG)
HOMELINK DIAGNOSTIC IMAGING PROVIDES YOU WITH:
ACR-accredited imaging centers with board-certified, sub-specialty trained readers.
TIVE SAV IN PEC G OS
GS
RO
IN
R
ET
S
RE TR
RESULT S P E C TIV E S
AV
Prompt scheduling and reporting to the referral source.
Unmatched level of customer service and support.
• Positive patient contact within 24 hours • Reporting within 48 hours of study
Timely, accurate diagnostic tests that improve outcomes and lower your costs per claim.
RETROSPECTIVE BILLING WITH NO ACCESS FEES
Send us your existing claims and allow us to unlock additional savings.
HOMELINK | Summary of Services | 23
HOME SLEEP TESTING
Supported by medical findings cited by CMS, Home Sleep Testing is replacing traditional costly facility studies.
IMPROVE PATIENT EXPERIENCE SLEEP LAB TESTING
HOME SLEEP TESTING
THE PROCESS
Night spent at the sleep lab, numerous electrodes applied
Device delivered, 3 or minimal sensors applied before bedtime
REFERRAL TO TREATMENT
2-12 weeks
2-5 days
KEY DIFFERENCE
Ideal for seriously ill patients and complicated cases
Simpler and less expensive
BILLED COST
$1,600-$5,000
$325-$350
WITH HOMELINK HOME SLEEP TESTING YOU GAIN ACCESS TO A comprehensive program offering a cost-effective and time-sensitive solution for diagnosing and treating Obstructive Sleep Apnea (OSA).
24 | HOMELINK | Summary of Services
A national network of providers to set up diagnostic studies and, if necessary, the autotitrating CPAP.
Resupply service facilitated by HOMELINK.
DENTAL
POWERED BY EZ DENTAL CARE
HOMELINK’s Dental Program, powered by EZ Dental Care, delivers the most comprehensive and cost-effective way to manage workers’ compensation dental claims at a national level, assuring only injury-related treatments are provided and patient satisfaction is achieved.
1
SCHEDULED TURNAROUND
Within 2 Business Days
100%
2 REPORTING TURNAROUND
Within 2 Business Days
97% 3
APPOINTMENT FOLLOW-UP
Within 2 Business Days
95%
DENTAL CLAIM MANAGEMENT INCLUDES Injury Assessment & Treatment Experienced dental care expert manages your dental claim from start to finish with each dental provider involved.
Treatment in Progress HOMELINK can pick up your case at any point. We’ll start with our dental treatment review and begin coordination of work-related dental treatment.
Treatment Plan Audit HOMELINK can assist in reviewing the treatment plan, explaining the treatment, and providing a concise written summary.
Dental Peer Review A qualified dental provider reviews all supporting medical documentation to answer questions and provide a comprehensive report.
HOMELINK | Summary of Services | 25
HOMELINK INDEX OF SERVICES HOME MEDICAL EQUIPMENT • • • • • • • •
Beds Wheelchairs Scooters Patient lifts CPM machines Cold therapy Aids to daily living Custom, manual and power wheelchairs
MEDICAL SUPPLIES • • • •
Ostomy Colostomy Wound care Incontinence
DIABETIC EQUIPMENT AND SUPPLIES • • • •
Insulin pumps Glucometers Test strips All supplies
BONE GROWTH STIMULATORS • • • •
EBI Orthofix DJO Exogen
TENS-ELECTROMEDICAL • • • • •
Medi-Stim 23T Premium TENS units Muscle stimulators Interferential stimulators Galvanic stimulators
26 | HOMELINK | Summary of Services
ORTHOTICS AND PROSTHETICS
• Upper and lower extremity prosthetics • Orthotic braces and supports
NURSING AND THERAPY SERVICES • RNs/high-tech RNs • LPNs • Home health aids/CNAs
PHYSICAL MEDICINE • Therapies: PT/OT/ST • Acupuncture • Chiropractic care
IV THERAPY • • • • •
IV antibiotic Pain management TPN/enteral therapy IVIG/anti-coagulant Hydration
ACCESSIBILITY MODIFICATIONS • • • • • • • • •
Home, vehicle and workplace modifications On-site evaluations with project manager Driving evaluations Towing services Vehicle inspections Vehicle lifts Adaptive equipment Van and truck conversions Vehicle purchases
HOMELINK SERVICES INCLUDE, BUT ARE NOT LIMITED TO: CATASTROPHIC CARE COORDINATION • • • •
Closed-head injuries Quadriplegics/paraplegics Burn patients Amputees
MEDICAL TRANSPORTATION • Ambulatory • Includes rideshare (UBER, Lyft) • Wheelchair • Stretcher • ALS/BLS • Air ambulance • Commercial transportation • Air travel, bus • Hotel accommodations
MEDICAL AND LEGAL TRANSLATION • • • •
Onsite Qualified interpreter Telephonic Document translation
RESPIRATORY THERAPY • • • • •
Oxygen (gas and liquid) CPAP/BiPAP Nebulizers Ventilators Respiratory supplies
HEARING HEALTH CARE • • • • •
Hearing aids Hearing evaluation/testing BAHA accessories Cochlear implant accessories Hearing aid batteries
• Wax filters • Custom ear molds • Hearing aid accessories
DIAGNOSTIC IMAGING • Advanced imaging • MRI, CT scans, PET • Standard radiology • Electro Diagnostics • EMG & NCS
DENTAL CARE • • • • • • •
General dentists Endodontists Oral surgeons Periodontists Prosthodontists TMJ specialists Xerostomia
HOME SLEEP TESTING • • • •
Online enrollment and screening Diagnosis of obstructive sleep apnea PAP therapy setup and instruction Compliance coaching by our staff
WOUND THERAPY • Wound vacs • OxyGeni
POST-ACUTE CARE • • • • •
Long-term care (LTC) Inpatient rehab Skilled nursing facilities Coordinated discharge program Claim analysis
HOMELINK | Summary of Services | 27
1111 W. San Marnan Drive Waterloo, IA 50701 800-482-1993 | homelinkreferrals@vgm.com | VGMHOMELINK.com
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