Big things are happening in the medical sector. It's one year later and the Obama Administration continues to forge ahead with its controversial healthcare overhaul. Even at press time, opposition is about to come to a head with newly appointed Speaker of the House John Boehner planning to propose a vote to repeal the law known as ObamaCare. Whatever the outcome, change is inevitable in this fast-paced industry. But that's what makes it exciting—even in the print world.
Oxnard, California-based TFP Data Systems' core products have always been tax forms. However, more than 30 years ago, the company realized its core competencies are compliance and maintaining relationships with government agencies. The natural next step was to use this competency in the healthcare market. "We also realized that healthcare was a growing market and it opened up a whole new set of dealers and dealer opportunities," noted Jim Magdaleno, product manager, healthcare.
Today, TFP Data Systems' best-selling medical product is the CMS-1500 laser billing form and companion envelope that is required for all non-institutional insurance billing (which encompasses almost everyone within the medical sector, according to Magdaleno). In addition, the company has HIPAA (Health Insurance Portability and Accountability Act) Essentials on CD-ROM which includes the most popular office forms in healthcare.
That's not all TFP Data Systems can produce. "We provide and support the billing mechanism and front-office medical products that include: CMS-1500 and UB-04, software, ADA statements [and] envelopes," Magdaleno said. "We are in the process of upgrading our eight-page healthcare catalog to 24 pages to capture all the new products in the HIPAA arena such as compliance essentials, labor law posters, HR forms and software and healthcare-related coding products for the front office."
Magdaleno went on to explain what he believes to be one of the biggest problems in this market, and shared the TFP team's solution. "For the sector we serve, it's the billing system and the need to simplify the administrative flow of data to lessen the burden and cost. We do this by working with organizations that support the products we provide to make sure we deliver the most compliant of products to help eliminate the chances of a billing claim being rejected," he stated.
Jessica Wenz, product marketing specialist for Dayton, Ohio-based Wilmer, shared another major area of concern—market fraud and theft. "There are many accounts of prescription theft. It can be the prescription pad itself, or the actual medication," she commented. "Wilmer places layers of security features on all of our prescription scripts to help combat the fraud. Some companies may only apply enough security features to meet the Medicaid requirements, but we take extra precaution in hopes of keeping our end-users safe from their scripts being reproduced and used on the streets."
Wilmer also spends time fulfilling requests for thermal roll products. In an effort to cut costs and waste, companies are reviewing what they use and how they use it. Wenz has recently observed a larger interest in using thermal rolls to print prescriptions. "[Companies] can purchase a much smaller printer and print the script that cuts off directly at the 'end' of the script. There is virtually no waste."
Nevertheless, arguably one of the hottest medical-related topics in the print industry is the move to electronic medical records (EMRs). Nearly two years ago, the Obama administration announced plans to spend $40 billion to help doctors and hospitals adopt EMRs. Last July, the administration released a detailed five-year plan for moving healthcare providers to electronic records. What does this mean for print providers?
TFP Data Systems is researching new products that are a platform to support the electronic segment it serves. But, Magdaleno doesn't foresee the end of paper-based forms just yet. "Even with electronic filing, medical facilities still print a copy for their records because a resubmission of a claim is common and, in most cases, requires attachments. … Paper billing forms are still necessary at least for now and there's no question that electronic filing is here, but there is still a controversy regarding cost to convert," he said.
Magdaleno continued, "In 2008, the numbers given by the CMS [Centers for Medicare & Medicaid Services] and HHS [U.S. Department of Health and Human Services] were $30,000 to $50,000. In 2010, the new number provided by an independent study could hit $120,000 per physician, with 84 percent of that cost ($101,250) being lost revenue from fewer patient encounters during the transition."
Looking ahead to the more immediate future, the migration to ICD-10 and 5010 will present new opportunities. "The [HHS] has released two final rules that will facilitate the United States' ongoing transition to an electronic healthcare environment through adoption of a new generation of diagnosis and procedure codes and updated standards for electronic healthcare transactions," Magdaleno declared.
ICD-10 codes must be used on "all HIPAA transactions, including outpatient claims with dates of service, and inpatient claims with dates of discharge on and after Oct. 1, 2013," according to the CMS website. Failure to cooperate may result in the rejection of claims and other transactions. If this occurs, they will need to be resubmitted with the ICD-10 codes, which could result in delays and impact reimbursements.
On Jan. 1, 2012, standards for electronic healthcare transactions (including claims, eligibility inquiries and remittance advices) change from Version 4010/4010A1 to Version 5010. Version 5010 accommodates the ICD-10 codes, and must be in place before the changeover to ICD-10.
Because of continual updates and revisions, extra research is a necessity. Suppliers like TFP Data Systems and Wilmer invest a lot of time in education to ease the burden for distributors. When asked how to ensure customers remain "happy customers," Magdaleno responded, "Provide the most compliant products and deliver on time. We also research new products to sell, and we provide a menu of products and services our customers can choose from that will fit into their business development plans. We provide trends and analysis that will help them make the right choice."
Wenz added, "I have been attending the CMS meetings, in-person and by phone, to keep up with where they are in their decision-making process. I come back from these meetings with new information I can pass along to our sales reps, customer service reps and our distributors. Being proactive and keeping everyone informed about the process gives them one less thing to worry about, or one less phone call to make."
So what's the official diagnosis? A nice life with minimum side effects.
"I don't believe [the healthcare industry] is dying; it's in a transformation process," Wenz concluded. "While we lose some sales in one product, we have new products that are picking up sales."
Magdaleno predicts distributors will find great success in the medical sector in the next five years. "Educate yourself as much as you can and find out where you fit in within the landscape of healthcare sales," he asserted. "Remember, 'keep moving forward, don't stand still.'"
For more information about TFP Data Systems, visit www.tfpdata.com.
For more information about Wilmer, visit www.4wilmer.com.
- Companies:
- TFP Data Systems
- Wilmer