A guy walks into a car dealership to buy a sporty import from Italy. The price tag is north of $100,000. The dealership says the car is coming from Italy and delivery can be in about 8 weeks. They take a sizeable down payment and order the car and do an admirable job of keeping the customer informed of the progress of the car’s journey from Northern Italy to the US and into the customer’s garage. There’s a slight delay, but the dealership keeps the customer informed and he’s happy to accept delivery of his dream car just over 9 weeks after the day he walked into the dealership.

A guy brings a car into the same dealership for service. It’s an import too, and is about 15 years old. The service department takes down his information and an hour later after some speedy, efficient research tells the customer they can’t get parts. They suggest a bigger dealership that specializes in the specific brand of car about 50 miles away, and even call the dealership on his behalf to verify that they service that type of car.

Finally, a customer who recently bought a new car has a service issue. The warranty covers the repair—both parts and labor. Parts take a few days to come in and the repair will take the better part of a day, so they expect it’ll take them about 4-5 days to get the repair completed and return the car. Because the car is less than a year old and has an unexpected issue, the dealership offers the customer a “loaner car”. In fact, they offer a more luxurious, more expensive car to use as a loaner.

All three of the above scenarios result in satisfied, happy customers. The customer service builds brand and dealership loyalty. Sadly, that isn’t always the way it goes when buying cars or taking them in for service.

Now, draw an analogy to the DME industry. Do we keep our customers (patients!) informed as to when product is coming in or how long it will take to get some needed part or supply? When a potential customer comes to our company for some product or service, what do we do if we can’t provide it? Are we able to refer them away to another company and help them connect with a provider who can help them? When repairing or providing equipment service, are we able to do repairs quickly and efficiently? Can we help a customer with replacement when equipment is broken or lost and can we provide loaners while repairs or maintenance are done?

Turns out there’s an accreditation standard for that! PS 1 –the so-called “Patient Acceptance” standard addresses all that and more and requires us to plan for those eventualities and make sure customer/patients get the care and service they should expect.

Standard PS 1
Client Acceptance/Services
The organization admits for service only clients who require the services within the scope of practice that the organization, or its contracted providers, can provide. The organization describes in policy the standardized processes that include, but are not limited to:

• Timely intake and acceptance of referrals or requests for service
• Informing clients of acceptance or denial
• Validating client eligibility for services
• Verification of client benefits to be used for payment
• Verification of the receipt of the items or services by client
• Provides for appropriate and informed termination of equipment or services to a client
• Maintaining client dignity, privacy, and respect
• Ensures that all staff respect client property while providing services in client residence
• The organization provides a loan or replacement of any equipment or device in the event of failure, breakage, or questionable performance for any item or loan to a client
• Informing in a timely manner referral source (and physician if required) if item/service cannot be provided as ordered, but in no case more than five (5) calendar days, if it cannot provide the equipment, items or services that are prescribed for a client
• Timely follow-up as needed consistent with the types of equipment, items and service(s) provided, and recommendations from the prescribing physician or healthcare team members.

Breaking the standard down, it is essentially asking organizations to adopt a standardized process to admit customer/patients to service. The process should be framed with a well written policy that addresses the bullet points contained in the standard. The process should include the organization’s scope of services and describe not only how they admit a new patient to service, but also how they handle patients whose needs are not something the organization can help them with.

Notice that the standard doesn’t say you have to take a patient. It does however require that you have a fair and speedy process to let the patient and referral source know whether you can service the patient or not. Beyond the fact that you simply don’t provide a certain type of equipment or supply, there are numerous other reasons why you might not admit a patient to service. These include distance from your company (location) and insurance payer issues. The important thing is that you have a reasonable and speedy process to verify that you CAN (or CANNOT) provide care and that you inform the patient and referral source. At all times through the process, patient dignity, privacy, and respect should be maintained.

Timeliness is an important concept here. The policy and actual practice as well call for “timely intake and acceptance” for new patients. It also calls for timely follow up once a patient is on board. Finally, it also expects the organization to notify the referral source or prescribing physician when they CANNOT accept a new patient because it is outside the scope of service and/or equipment is not available. In that case, the standard specifies that the notification should take place within five calendar days.

Companies generally do pretty good with this and have well established policies regarding patient acceptance. Perhaps because of the internet and perhaps because the nature of referrals is dictated by payer contracts as opposed to the old-fashioned relationships between medical offices and vendors such as DME organizations, acceptance (or non-acceptance) is usually quick and efficient.

I think of this standard as a classic example of how accreditation standards are not only “rules” but good business practice. Like the car dealership examples above, these regulations set forth excellent customer service which can lead to future business. Many years ago, I remember a customer coming into a Pharmacy/DME where I worked looking for ostomy supplies. His ostomy was new and he had just moved to town and was searching (desperately, actually) for a place to get his supplies. While our DME did not carry those supplies, a very empathetic customer service rep helped him locate a place that did—actually a competitor. The grateful customer remembered the rep’s kindness and returned for supplies for his wife, who was on oxygen. Eventually, he switched over all their family’s prescriptions, including his wife’s oxygen.

Put a policy in place. Make sure all staff are aware and adhere to it. I promise your customers will notice and appreciate it.