How to Get DME Orders Through Legal Inbound Marketing

0:00Introduction

In the name of God, the Most Merciful. Peace be upon you. Today we bring a very important discussion to this session, and our topic is how in DME, within the DMEPOS segment, we should market, and how we can bring in organic orders and referral orders. With me today is Ansar, who manages most of our DME clients, and also oversees our own DME company overall. We will do our best to keep this session useful, and to cover the issues and problems that come up in marketing, or the tips and methods that bring us the most orders.

We will try to discuss all of that. Usually nobody talks about this, people tend to keep it hidden. But because our mission and vision are such that we want the outbound industry to move toward inbound and referral marketing, which is traditional, organic marketing. So for that, knowledge grows by sharing, so a session like this makes sense. So, let's start. We should begin with the fact that in inbound orders, the toughest and most challenging part is that when we send flyers to doctor offices, fax them, or email them, I know the hardest thing is reaching the office manager or social worker or referral coordinator. So in your view, how do we get past this difficult step?

1:32Reaching the right person at a clinic

And tell us about this topic. Yes, I will cover everything, how we start, step by step. First, we gather data and so on from Google and ZoomInfo, and then after that we do outreach.

1:52Flyers and faxes: what is legal

For that, we first make our flyer, which is for our DME, under our DME's name, stating which products and insurances we handle, because if we list every product and insurance on the flyer, every kind of order will keep coming, and when all those orders come, we will not be able to fulfill them, which will damage our relationships with clinics. So first, we make sure the flyer is good. Once the flyer is good, we mention the products and insurances we handle on it, so that we can send our flyer to doctor offices by fax and so on.

One thing I want to add here about flyers is that there are two ways to market with flyers. One way is that you cold fax them, which is very unethical, and if they want to opt out, your fax must include some option so that if they do not want to receive this marketing fax from you, you stop sending it. Because obviously, patient health and patient care are going on there, and they already have so much documentation to handle. A doctor's office is already swamped with it.

So if they also get marketing faxes like this, it becomes a big problem for them. Anyway, another way is to physically send it to their office, or to their PO box, so they do receive it. Its open rate is average, but it gets the job done. So one thing that came to my mind is that we can do this: on the flyer, mention at the bottom that if they are not interested, they can tell us, so we will not fax them, and we will note it so that we don't send faxes again and again.

Our first priority is to call first, get the fax number and email, and try to connect with the decision maker so that orders keep coming in as soon as possible.

3:30The first call and the decision maker

The main thing here is follow-up. The more consistent your follow-up, the better the results. First, it takes time to build a workflow. One month, two months, even several months, for your workflow to get set up. Then clinics see you and see your service. The important thing in this is that if someone is giving you a patient's order, they check how many days it takes you to fulfill it, so this is very important.

3:59Fast fulfillment earns more referrals

If you treat the patient well, say on the first order, you fulfill quickly and deliver the equipment quickly, that is what they want, because it reduces the burden on the doctor's office. One more thing I want to add: people who work in the outbound segment will never be able to accept this, because I talk to a lot of these people. Those who are in the outbound segment, I mean, they just want money. Payments come in on Net 7 or Net 14, and they bill medium-ticket items, they bill braces, and they bill CGMs, so with braces, say, they get a decent margin, and with CGMs they keep $100 to $150 too, if they are buying from a good vendor who gives them very competitive rates. So obviously, when you start DME inbound, you will start with mobility products, meaning canes, crutches, walkers, and rollators.

5:03Which products to start with

Obviously, if you have a good biller and a good vendor, then depending on your accreditation you can also go into oxygen supplies and also bill incontinence supplies. But if you have no experience, you should start only with mobility products, which can also be drop shipped. And you can't do hospital beds either, because you have to go there and do the full setup for a hospital bed and look after everything. Anyway, on inbound, as you said, building the whole pool does take time, one to two months, until, I mean, four or five doctor offices start giving you orders.

5:41Building a clinic pool takes time

But later on, because it is a plant, it is an organic journey, traditional marketing. Once this plant is planted, later it bears fruit. One thing I want to add: mostly it is time-consuming, but it pays off in your future, because when you build a pool of fifty clinics, look at it this way: every clinic that gives you even one order a month means you get fifty orders a month. So your pool of fifty is built. One clinic will give two orders, another will give three, so the working pool keeps growing.

But in this, this is work for your future. Now, in outbound, what happens is that you have to buy leads, do chasing, and a lot of other things. The costs add up. With inbound, you are directly connected to the clinic, and it has a future, and you are not doing fake work. And those in outbound want to make money as quickly as possible. In that case, if you have a budget, you can run your ads and so on. We are saying this for those who basically run small setups. For them, out of pocket means building a good store.

6:51Out-of-pocket sales and higher-ticket items

For instance, if you work under a DME umbrella that has accreditation and its PTAN, I mean, for out of pocket you of course don't need a PTAN. So yes, you can build a whole store and work on out of pocket, and again, the same thing: work on out-of-pocket items. For instance, an item where at least your profit margin is $40 to $50, because once your ad matures after two or three months, roughly the ad cost for one product will be around $30 to $35, I think.

So you keep about $10, $15, $20, or $25 per product. Then if you have three hundred, four hundred, five hundred orders, they add up to a decent amount. And then, again, yes, you can also go on to high-ticket products, rehabilitation products, all on an out-of-pocket basis. But again, in the United States out of pocket is a 20 to 25 percent market, and a lot of people miss out on this segment. Our purpose in making this video is that the small call centers, since they can afford RingCentral, can fax, email, and cold call to connect with doctor offices.

8:00Outreach team costs and consistency

Just, in this, you need consistency first. Now, one problem here is also that, again and again, when you talk about small call centers, a small call center does not have a budget here. For instance, if they do inbound marketing, and for a DME, I mean, you can see for yourself how many walker and rollator orders and how many CGM orders they would have to send for their expenses to be covered. Say a small call center's expenses are even $2,000 to $2,500, then to cover that they would have to bill at least $10,000 to $12,000, because then there will also be product costs, then the cost of a U.S. office too.

Only then will their $2,000 to $2,500 be covered. So in my opinion, to bill $10,000 to $12,000, at least at least, they would need some twelve or thirteen doctor offices that are giving them roughly three or four orders a week. And if, yes, they also know how to do billing properly. Because just giving the patient the product and billing is not enough if the documentation is not clear and not audit ready.

9:05Audit-ready documentation

We do see this, clients come to us too, and in fact today we were discussing an audit a client received from the RAC, who review records and samples and then send out audits. But in this one, the wheelchair add-ons documented as given to the patient were not in the SWO. Medicare's guidelines say all add-ons should be mentioned in the SWO. Anyway, this came to my mind and I thought we should discuss it. Yes, so basically what we say is that your flyer should be good, the flyer should be good, and give them only the equipment you provide, because if they send orders for other equipment, you cannot fill them, and then the patient's equipment will be delayed.

When it is delayed, your relationships will suffer because of it. So keep this in mind when you do this. First, gather their data, and in this, if you follow up with consistency and keep following up with them, send flyers, send emails, and give good patient care, it will take you two to four months for the pool to build. If you build the pool well, then in this, the way we are using AI, where AI is proving useful, meaning in building a good, brilliant workflow, because with AI we can now put Apps Script on Google Sheets too, big, elaborate scripts that used to take a lot of time, so that we get reminders automatically, how we can add Google Calendar, how we can build a next-level, disciplined workflow.

10:33Using AI in the outreach workflow

This too, especially, this discipline also needs to be discussed. But I want you to cover it quickly, because the video will get very long and those with short attention spans will run away. So basically our step by step is that we first have to gather data from ZoomInfo and Google.

11:03Finding clinics and contacts step by step

First, whichever specialty fits the equipment we are providing and the insurance we accept, we go to their website and check whether this specialty is right for us or not. Then, once we have its data, we will reach out to doctor offices and tell them our services, what we can do. And then get their fax number, email, and the decision maker's contact information. On the very first call, it is hard to reach the decision maker, so the first attempt is to get their name and fax number and send them a fax and an email as your first email.

And in this there is a benefit: you will not get much rejection, because you are taking a burden off them. Because in most cases, most DMEs work on specific products only, so because of that, they have to give orders to different DMEs. So to save their time, when we offer them that we will deliver equipment as fast as possible, why would they choose anyone else? Because we are providing equipment quickly and giving them all their documentation as fast as possible, and doing everything on time, and we are also handling patient responsibility properly, so they will choose us.

So if you go to the right person with the right pitch, only then will you get good results. In this, it takes time, so you need patience, because it is long-term work. It is not all at once, in a snap. Consistency is very important in this.

12:31From clinic referrals to a patient pool

So this is our workflow: we take inbound orders directly from doctor offices. That way we avoid fake work and we avoid outbound, but fewer orders come, but good ones come. And once you have built a pool, then a lot, like how much of a provider relationship we are building. Then there are refills, then recurring supplies. CGM too, if you have a patient pool built, they keep getting refills. There are diaper patients, catheter patients, and so on. Like, say, we built a pool of a hundred incontinence patients, then our CGM pool was built, and rental equipment.

So we end up with a hundred or two hundred patients accumulated like this, and after that we keep getting monthly income from them. Now, the biggest challenge I have seen here is that, well, this is a discussion in itself, that the real, the real, I would say the skill, is that you manage the patient pool well, with efficiency, because obviously, when your patients grow, then lags start to show up and issues start to come into the workflow.

13:38EMR, refills and documentation discipline

So if you have a good EMR system, you can also use our customized one. If you want, we can recommend our own custom EMR EHR software to you, anyway. But in this, what you have to manage in a timely way, I mean, is the whole workflow, to watch the whole pool, and the biggest thing is that there must be no lapse in documentation. Say a patient's refills are going, and while refills go out, for instance, their prescription has expired, and no notification came up to renew it, and it was not renewed, and then tomorrow if an audit comes, obviously, all that payment will be recouped, if a post-payment audit comes, so you have to make sure of this as well, that you run your workflow with a lot of discipline, whether it is the marketing workflow or patient care after orders come in.

You have to run this entire workflow with a lot of discipline, because in DME, from my small experience, what I have seen is that you get paid on time. With Medicare Advantage, with Medicare Advantage you get paid a little late, but Medicare FFS audits are very strict, and their recoupments and their repayments, their audits are very strict, so if you have complete documentation, and you are sitting audit ready, then you are safe. Otherwise, you will lose all the money you have to pay back to them, and your equipment will be gone too.

If your equipment has gone to the patient, and then you also have to pay Medicare back, think how far into the negative you will be. How will you keep running? So these things need attention. So basically this is how we take inbound orders, and we now have more than two years of experience with organic, we started it ourselves, and by making mistakes we built a workflow, Alhamdulillah, our facility is doing quite well.

15:36Lessons learned and follow-up etiquette

In it, if you onboard some five or six, or two or three hospitals, they alone will keep giving you 17 to 20 orders a day. So you only need one or two home runs to land, some hospitals getting onboarded, and you remember that at the start I used to talk to you about such home runs, that you swing, sometimes the ball connects and sometimes it doesn't. It is like that. It is this thing: consistency. Yes, in this, consistency is very important. It is not the case that orders are not coming if you are following up with the right consistency, if you chase every lead properly, it will be a yes or a no.

If it drags on for two months, three months, you set up a workflow that says after this many days I need to reach out again. Now, don't irritate them all the time. Their job is patient care, so size up the other person and judge when I should call, and it is all about permission, so they do not get irritated. Keep this in mind too. My idea, what I have understood, is that if you have a provider relations officer who is doing inbound marketing, and if, for instance, he works eight hours, then in a day he can do, say, 60 to 65 clicks.

By clicks I mean he can take 60 to 65 actions. From my experience, he should not be overloaded in this either, because obviously this involves a lot of planning work, so if he makes too many calls and so on, he will not be able to do it. So instead of going for quantity, quality matters. So if he is making, for instance, 30 to 35 calls in a day and doing customized work for each facility, looking at the whole facility, using AI to do research on them, finding their weak points, and going into the right specialty to get the right product, and of course, within the right specialty, to the right person.

17:34Researching the right specialty

If he wants CGM orders, he will go to endocrinologists, and in an endocrinologist's office he has to reach the referral coordinator or the office manager or the social worker. The front desk person has nothing to do with this. So, if this work is being done with discipline, and this work, I mean, it is the same big point: if you hold the shovel properly, then you will be able to dig, but if you hold it upside down, how will the digging happen? So this matters a lot in this, that, brother, there should be effort, but in the right direction.

If in one go the next level is not designed properly, because of that weakness problems will come later. Yes, one more important thing is that our Asian people somehow find a way to scam, so in this too, they should not start scamming, grabbing orders and passing them to another DME.

18:37Scams, shell LLCs and fake billing risks

This is a very big problem. So in this, this is against the rules. You cannot market for some other DME and sell the orders, because that is not allowed. So be very careful about this too. Yes, this point is absolutely right. Obviously, when we were thinking of doing all these sessions, we thought, now that we have learned how this works, let's teach it to everyone together. So the most important point that we used to discuss was just this: obviously, now people do not even know that work can also be done this way, most people, 80 to 90 percent of them, do not know this, but obviously that 10 percent are the people from whom we learned this work, so I also want to thank them.

May God bless their livelihood and grant them every goodness. But our discussions kept going on this, that this work should not get spoiled, but now obviously the bigger risk is what is currently running in the market: outbound work, and LLCs and shell companies set up with straw owners, through which labs and DMEs have fake billing, abuse, and waste, and this kind of billing is going on, which is more dangerous, because in our industry there are many people who, if they see the right light, will do absolutely the right work.

Our effort too is that this video's purpose is so that more people take this up. Those who do real work, for whom so many products now require prior authorization too, yes, and a lot of work has stalled, and all these speed bumps and all these checks have been put in only on those products where the most improper billing happened. This happened because of those that became required, one after another, first on wheelchairs, so it is all because of that. So okay, I hope today's session went well, and was very useful for you, and to those who are watching to the end, thank you very much.

And I always say that to listen to us, your attention has to be very good, because I also speak very slowly, Ansar also speaks very slowly, but that's fine, in editing we will speed it up. But, God willing, we are making every effort. We have decided that we will not stop these sessions, and the course we are also running on YouTube will continue too, because obviously, a series has started, so thousands of ideas keep coming to mind, but then there are operations too, there is work too, because we are also handling audits for DMEs, and the operations of DMEs too, and besides that we are also working with those who need to set up a whole DME, working with lawyers, working with payment partners.

21:04Closing

So yes, we have many options in one place, you can say there is everything available. And yes, God willing, we will meet soon in the next session and find the most important segment worth discussing. Thank you so much, everyone. May God reward you. Peace and God's mercy be upon you.