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Is there a single right way to run a home care agency? We sure don’t think so. That’s why we’re interviewing home care leaders across the industry and asking them tough questions about the strategies, operations, and decisions behind their success. Join host Miriam Allred, veteran home care podcaster known for Home Care U and Vision: The Home Care Leaders’ Podcast, as she puts high-growth home care agencies under the microscope to see what works, what doesn’t, and why. Get ready to listen, learn, and build the winning formula for your own success. In the Home Care Strategy Lab, you are the scientist.
Miriam Allred (00:01.026)
Welcome to the Home Care Strategy Lab. I'm your host, Miriam Allred. I hope everyone is having a great week. It's great to be back in the lab. Today I'm joined by Greg Bean, the Vice President of Revenue Cycle Management at AxisCare Greg, I think you know more about VA billing than anyone else in the industry. You might have to prove me wrong on that, but I am excited to...
Pick your brain on all things VA billing. It's such a hot topic and you're an expert when it comes to this lane. And so we're going to dive in and talk about ways to streamline VA billing and also increase those VA billable hours. So before we jump into the topic, talk to us about your background. I know you've been on a lot of stages. A lot of people know you and have heard you speak.
So share maybe the things that people love to hear most about you and your background, and then also sprinkle in maybe a couple of personal things that people don't know about you.
Greg Bean (00:59.336)
Well, thanks for having me first and foremost. So, you know, I think one of the driving forces behind all of this for me is I joined the Navy at the ripe old age of 17. So, you know, I grew up on a ranch in Northern Idaho. My folks had a ranch and I decided to jump off and join the Navy at 17. Following that, I spent several years working in the acute care setting, trauma, emergency nursing, acute care.
And then a friend of mine said, hey, let's start a home care company. And then look, here we are 30 years later, working through all of these environments. You know, I think one of the driving forces behind all of this for me and what makes it a huge piece for me is, you know, I look back at my grandfather and both of his brothers were in the first European conflict. In fact, captured and was a prisoner of war in Stalag 13.
So if there's any Hogan's Heroes fans out there, he was in the real style, like 13. It wasn't quite like in the movies. My dad then was a part in the Navy and his brother and my other uncle on my mom's side. My brother was Army, my sister was Air Force. I was obviously Navy. My son-in-law was a Marine. And so now I see even my son's active duty serving in the Air Force. So the military, the VA, the world is a passion for me, but it's also a lifestyle.
Miriam Allred (02:25.646)
Wow. And you have, like you just said, you've been in this in and around the military and home care for 30 years. I don't know that we need to go that far back, but I want to preface this conversation with the changes you've seen in the VA, maybe the last 10 years in home care. A lot has happened just in the last 10 years. Can you just share from your perspective some of the changes that have happened when it comes to the VA and home care over the last maybe decade or so?
Greg Bean (02:55.796)
Yeah, I think one of the big things in home care from my own personal thought process around what's changed, what hasn't changed, what's better, worse and so on is in the home care space, so many people aren't aware that they have a benefit. And it isn't something that the VA puts out there. They say, hey guys, that you can be getting services or girls, you can be getting service, men, women, whatever it might be. It's not something that's published by the VA.
It's not pushed by the VA. And when we look at the total number of veterans in the United States with over 20 million, and we think about the fact that in today's world, only 175,000 veterans are getting home care. So when you think about that, that less than 1 % of our veteran population is getting care, it really becomes a paramount objective and an expectation of home care companies
to actually go out and educate veterans and then help them to get services. So one of the things that I've seen is there's been a massive push the past few years for home care. 10 years ago, the VA didn't pay well. It wasn't a great service. I mean, it was a great service to the veterans, but it wasn't a great service for home care companies. the pay was low, the issues were problems and so on. And so they had waiting lists of veterans to get care from home care companies.
Now home care companies are observing this not only as a need in their community with their veteran population, but also as an opportunity to grow their business. So now we see agencies actually standing in line to provide care for the veterans. So it's come full circle from veterans not having enough service to people standing in line saying we need to go out and educate people so they can actually receive benefits and care.
Miriam Allred (04:42.156)
I don't know if this is a naive question, but why do you think the VA isn't more public and vocal about the benefit? it something political? Is it just like a lack of marketing function? Why aren't they more vocal?
Greg Bean (04:55.07)
No, I think it's genuinely budget related. I hate to say that. I hate to go down that path. But the reality is, that it's never been a law or a requirement that they provide this benefit back to our veterans. So each VA regional medical center has had their own idea of how much of this care they wanted to support. So you'd have one hospital saying they'll give a veteran four hours a week of care.
and others saying they're going to give them 40 hours a week depending upon what they've individualized their budgets and created in from a budgetary standpoint. So it's been budgetary. It's been driven by the local environment of each regional medical center and not a big push by the VA on a national level. know, one of the things that happened with the Dole Act in this last year is it actually codified the Homemaker Home Health Aid program into law. So now,
it's not a matter of whether the VA hospital wants to support this service or can support the service. It's actually mandated. So it does allow for us to really help veterans to understand they can get the benefit, but then also they're mandated to provide the care to our veterans. So it's changed drastically that way.
Miriam Allred (06:03.694)
And like you said, it puts the burden on the home care agencies, but also it's the opportunity for them to position themselves as the one to kind of solve the puzzle and be that resource for these veterans.
Greg Bean (06:16.54)
So I think that's been the biggest shift is home care companies are understanding they need to go out and educate the community and be a part of this industry and environment. It's not something that they've focused on or been a focal part into home care. It's predominantly around private duty, private pay.
personal services, things along that line. And they're saying, wait a minute, we have this massive population of 20 million veterans with over 10 million over the age of 65. We should be supporting them and getting benefits and care and supporting them back in the community. I think it's been a huge focal point of the industry over the past few years and it's really enhanced the amount of people getting care.
Miriam Allred (07:01.102)
We'll talk more about that education piece, because that's a key part of the puzzle is how do you get out in front of these people? How do you produce resources, marketing material that attracts them and helps them understand the benefit? A couple more questions before we jump in. Just the supply of home care companies has gone up substantially in the last decade. And like you mentioned, also the demand for VA coverage and VA services to be covered.
Are there, is it realistic for smaller home care companies to still be contracted by the VA or has that ship sailed in some states and most states? Like are there still opportunities or has it been saturated heavily the last few years?
Greg Bean (07:45.736)
I think one of the things if I was looking at that as a home care company is where are the areas saturated? If you were in a very saturated market where there's a great deal of home care companies already providing services back across the VA, you're going to be very challenged to get into network. The networks are managed by two different platforms, one being TriWest and the other being Optum. They don't actually decide who gets into network. It's actually decided by the VA that way.
They're the credentialing bodies, but the VA hospitals themselves say, hey, we don't need any more providers or we need more providers. So your remote areas of the country are still in need and even remote areas around your rural area. even you and I would use, I'll throw like an Atlanta out there. Atlanta proper Fulton County might not need assistance, but there's surrounding counties all the way around Atlanta that might.
So as you look to, there's still a massive need. There's still a huge veteran population. So I would encourage all agencies to get enrolled, to work towards enrollment, and to work towards providing services back to veterans and educating them back into the community. Because if you were to ask somebody in your neighborhood, do you know a veteran could benefit from free care, free home care? I don't think anybody can say they don't know a veteran who could benefit from free home care.
Miriam Allred (09:07.726)
Mm-hmm. And I'm glad you mentioned that rural piece. This is really top of mind for me because I recently interviewed the founders of ClearPath Home Care in rural Texas and they were saying when they started their business, they were almost 100 % private pay. 12 years later when they sold their business, they were almost 85 % VA because of the demand for VA services in rural Texas and their rural market. And so I think you're exactly right. More concentration.
less demand and maybe the metros but there's still lot of opportunities in the more rural parts of the country.
Greg Bean (09:40.616)
Well, and you start, if you start looking at the number of veterans and where they retire and where they spend their lives and where they are as we scatter across the country, you you may not see as large of a veteran retirement in inner city Los Angeles or inner city Atlanta, as you might see in some of the surrounding areas where you see people retiring, retirement age as they move into the more rural areas and communities to allow for themselves for retirement purposes. I think it's a big piece of what we do in this country.
as we try to sprawl and spread out a little bit as we retire.
Miriam Allred (10:13.998)
Yeah, that makes a lot of sense. Okay, let's jump in. We're going to talk about kind of five areas here that are important for streamlining and scaling your VA hours. I'm just going to recap them quickly and then we'll jump into each of them. So the first thing we're going to talk about is assessments, the actual care side, and then we're going to talk about care plans. Then we're going to talk about that education piece, educating the veterans, their families, even the caregivers. And then we'll spend most of our time about managing authorizations. You know, everyone
that thinks about VA has the headache and the due diligence to manage those authorizations. And then we'll talk about just monitoring the continuous improvement and scaling up those VA hours and being able to drive outcomes long term. So let's start with the assessment piece. So the care essentially comes down to how you structure that assessment and the care plan and making sure everything is
basically perfect so that the billing and the authorization, everything can flow from there. I know the tough thing when we talk about this is that it's so state specific and there's just a lot of nuances at the state level. But what is the general criteria for a comprehensive assessment when it comes to a VA client and how does that impact the billing?
Greg Bean (11:33.746)
Yeah, and so one of the things that I would say is so incredibly important about your assessment and your comprehensive assessment is it's going to dictate and actually work with every single thing we're going to talk about today. So it doesn't matter if we're talking about care planning, if we're talking about education, if we're talking about authorization management, every single piece of that ties into the assessment of the client. So what happens every single VA across the country
I know we have different state regulatory pieces and so on and so forth, but there's not a difference in state assessment for the VA. It's the same assessment. And that assessment goes through criteria around activities of daily living. Is the veteran able to dress themselves? Is the veteran able to feed themselves? Are they able to get to and from a bath or a shower? We want to make sure that as we're doing a comprehensive assessment, we're going step by step.
through the 15 different criteria that are created by the VA to make sure that we match that up with the client's need. So what the VA does is it takes this assessment, it takes all of these different criteria and it scores each section of it. At the end of that, it gives them a comprehensive score and that's how they dictate.
what they're going to be doing for their service authorization codes. they need this much care, they need these levels of care, then it dictates how many hours of care they get per week and what their service being provided is. So that assessment ties everything back to how many hours they get, the level of care they get, whether they're authorized for care at all. So understanding that when you're walking through the steps and doing your assessment is global.
It's not state specific, it's entirely across the VA and VA specific.
Miriam Allred (13:30.766)
When you put it like that, it sounds very black and white, there are pitfalls. There are maybe room for human error. Where are the mistakes made? If it sounds so black and white and anyone can do it, where are the mistakes being made by some of these home care companies when it comes to the assessment piece?
Greg Bean (13:48.518)
I think there's two pieces that are in error. One is the veteran themself and the challenge becomes the veteran says, I don't need help with that. So, I mean, every veteran that I've ever met, including myself, thinks we're too proud to get help. So, you know, I always use the example that the veteran has fallen, they're laying on the bathroom floor and they're on their cell phone and they're saying, do you get to the bathroom by yourself? They're like, I don't need any help.
In the meantime, they're stuck on the floor in their bathroom waiting for somebody to come pick them up because they're not going to tell you they need assistance. When you go in to assess them and you're having a conversation and they're having a conversation with this veteran, they're saying, do you need help getting dressed? And the veteran says, no, I don't need help getting dressed. In the meantime, their husband or their wife or their neighbor, their son, their daughter, whatever it might be, is coming over every day and getting them dressed.
Their need isn't that they don't need help getting dressed. It's that they don't necessarily want an outsider to help them getting dressed. So as we're doing our assessments and we're having this conversation with our veteran, we want to dig a little deeper into, do you need help getting dressed? How do you actually get your socks on? When you get to the shower, using a walker, using a wheelchair, using a shower chair, do you need help with feeding or eating? And they're like, no, I don't need any help.
No, when you put a plate in front of them, a fork, they can eat, but they can't get to the kitchen. They can't prepare a meal. They can't go grocery shopping to get their groceries, but they can eat by themselves. They don't need help eating. So understanding that diving into and being thorough in each one of those and making sure the family's aware when those questions are being asked, not just of you, but of the VA, that you're 100 % honest.
We never want to pad it or create fraud or lie or any of those things. We want to be 100 % honest, but honesty is so important and it's hard to bring out sometimes from our clients.
Miriam Allred (15:49.294)
You're speaking from experience here and so and you're mentioning what to do in that situation, but how can owners, operators, the people out in the field actually conducting the assessment break down those barriers? Because like you said, it's kind of a pride thing and this happens with all clients, not just VA clients, but any other advice about how to break down those walls and those kind of vulnerable moments with these clients?
Greg Bean (16:15.156)
Yeah, I think the real key here is how do I create a relationship with that client? You know, and do I sit down with them and do I listen? And I think the key here is listening to the veteran, listening to their story, listening to their input, listening to what's going on, and then genuinely educating and explaining to that person why you're doing what you're doing.
I'm doing this because I want you to get this level of care. I'm doing this because I want you to understand. I'm doing this because if you don't need help today, what if you need it tomorrow? What happens if your wife can't be there? What happens if your husband can't be there? What happens if your neighbor doesn't come over to help you? On that day, what do you do? And sometimes you have to get through to them to that. You know, I've actually had clients tell me, I don't do anything. I don't get out of bed if they don't come help me.
Miriam Allred (17:07.459)
We
Greg Bean (17:07.988)
I want to send Susie, the most amazing caregiver in the whole wide world, who is always going to show up and always going to be here. Take a little bit of that burden off of yourself and your family and in your life. If I can help you with a little bit of that, all of those people helping you are heroes. Let's give them some help as well. I think that's really getting that through to the veteran to understand that you're not just always about them. Sometimes it's about the people that are helping them that need that assistance as well.
Miriam Allred (17:37.422)
Yeah, that was really well said you said there was two things so that was kind of the client piece What's the second piece or the kind of second pitfall for owners conducting these assessments?
Greg Bean (17:46.866)
I think the next piece is what do we do with that information once we get it? You know, sometimes we're trying to go so fast and so quick and we just want to throw it out there and we're not actually taking that information and breaking it down and then using it appropriately. we'll talk about that when we talk about care plans and what we're doing and so on, but actually taking the information from the veteran, understanding it, and then doing something with it. What do we do with it after the fact?
How do we use that knowledge and how do we use it as we move forward? I think that's where the, first we have to get it, we have to get the client to be good with it, and then we have to take that information and transition it into usable insights.
Miriam Allred (18:31.384)
Let's talk about that. There are still paper assessments out in this home care world, meaning people are still conducting some of these assessments on paper. Obviously we're both biased. We have worked for technology companies that should take away all of the paper, but speak to the opportunity with technology to help. Like you said, it's collecting this information and then translating it and utilizing it and maximizing it.
what are the missed opportunities there? Is paper still the pitfall or what are agencies doing wrong to, with that information that they could be doing better?
Greg Bean (19:08.606)
Yeah, so how do we transition that onto a plan of care or an activities or whatever's going on with it in our automated world and within the platforms of account management systems or EMRs or SaaS product, however you wanna talk about these products as we go forward, you know, obviously I work for AxisCare. So with those things being said, how do I take that information?
and then move it forward and transition. How do I put it into a care plan? How do I manage it? When you're putting it on paper, how does it get seen at the other end? What happens with it? Does it stay in a book? Does the next caregiver see it? Does it get transitioned across to the case managers or your social workers or discharge planners over at the hospital? Is it going across to the client's physician who's signing off and saying that this is the appropriate levels of care? They need more, they need less, whatever it may be.
If I'm just taking that, I'm putting it on a piece of paper. The other thing is, is that what happens a lot of times, and I'm not going to throw the particular hospital under the bus, but one of our VA medical centers a couple of years ago sent me their assessment sheet. And like, this is the assessment we want our companies to use, home care companies. And it's like 10 questions.
And many of our home care companies were like, this is amazing, it's so simple and easy and all I have to do is fill this out and send it back across, right? But one of the things it didn't do was it didn't dig into all of those different pieces and parts. For instance, the VA, when they do that same assessment, it asks the question, do you need assistance with dressing? And then there's five different categories inside of that that they check off.
And if you put on there doesn't need assistance with dressing, they're going to give that client a zero.
Greg Bean (21:03.358)
So understanding that if you're going to use paper and you're not going to have all this built into your automizations, you have to have all the detail into that paper. You can't come up short. You have to make sure because at the end of the day, this is gonna dictate how much care the veteran got. It's gonna dictate what levels of care your caregiver's providing on the back end. And at the end of the day, it's gonna dictate how well we're providing care to the veteran and what services they're getting.
which is ultimately all that really matters.
Miriam Allred (21:35.67)
Yeah, you know what's coming to mind? I've heard lately, I just heard this actually from an owner, that they can get care started turnaround time of like four hours. I think a lot of agencies have this metric of how quickly they can start care. Don't get me wrong, that's a great metric that shows that you have your processes in order and speed is a priority. But I like what you're saying about
being really thorough, you know, it might be a checklist of 10 items, but within those 10 items, there's probably 50 other sub items that are really thorough assessment needs to include so that the, you're doing right by the client so that you really uncover as many needs as possible upfront. So yeah, what, yeah, thoughts on that.
Greg Bean (22:19.656)
No, I think you're 100 % correct. And in my mind, the wonderful part is, you should be able to get out and provide care in four hours. Get a caregiver there, get care started. But that doesn't mean that your clinical manager stops there, or your case manager, or your office manager, whoever's doing your assessment piece for you, still needs to make sure that they complete all of that assessment piece.
Miriam Allred (22:34.03)
Hmm.
Greg Bean (22:45.084)
Just because you got in quick to help that veteran really fast, that's amazing. I love the fact that they can get there so quickly, but you can't stop there. You have to complete the process on the back end of it.
Miriam Allred (22:56.406)
Yeah, really well said. think that's a great kind of like paradigm shift is yes, get someone out there, get care started, but don't cut corners on analyzing all of the needs and really doing all of that legwork upfront to make sure that long term the care is at the level that it needs to be. The other word that comes to mind is like bi-directional. So we talk about this assessment, we talk about gathering that information, but
All of this information on a client needs to be bi-directional because the assessment is kind of the first artifact at the start of care, but it comes back into play at the reassessment. as the care evolves, you kind of come back to that document. So all of this information needs to be bi-directional because really it all comes full circle as the care and the client needs evolve. Let's talk about translating it into the care plan. How...
how do agencies ensure that the care plan is now up to par after that assessment is done?
Greg Bean (23:56.606)
So I think that needs to be strongly built into whatever you're using electronically to manage your system. Each one of those tasks or pieces or parts needs to transition directly across. So if you say needs assistance with dressing, inside of that, it needs to say specifically what they need assistance with. for the last, also, you you said something to me earlier about what's changed in the last 10 years.
In the last 10 years, we've done everything we can to simplify documentation for caregivers. So we try to make the care plan the simplest possible, where all they have to do is check off shower. But if all they check off is shower, then that scores them like they're a visit in a shower, and it doesn't talk about the fact that they had to have.
a walker to get to the bathroom to use the shower chair to have assistance because each one of those things changes the level of their care within the grading system around an assessment. So when you're saying they need assistance with a shower and you're going to put that into the care plan, you need to make sure that any of the steps within that that are mandatory are also created into that care plan so that at the end of the day,
when you're taking that care plan and you're sending it back across to the VA to say, hey, Greg's doing amazing. Here's what happened with him, the veteran's care. Here's the documentation to say, I need more help. Why do you need more help? Well, here's the documentation that supports the assessment. But the nurse goes in and she assesses and she says, Greg had 52 falls this week and he needs more care and he needs hands-on assistance and he needs this. But the care plan didn't say anything about that.
and the caregiver checked off shower, shower, shower. So the care doesn't document the assessment. They don't match up. They're not going to look at that. So your care planning is so incredibly important that it matches your assessment. And then the provided care matches the level of needs of the veteran so that everything ties back in at the end of the day. The veteran got assessed for their needs.
Greg Bean (26:13.918)
their care plan was created around that need, and then the actual care being supported matched up to all of those things. It also lets the case manager come back or the care manager come back and say, hey, look, we know that Greg's needed this kind of help, but the caregiver's not checking that off. Is it because they actually don't need it? Or is it because the care is not being supported to the level it should be?
Miriam Allred (26:34.798)
But this is the golden question because the office wants to keep the care plan as lean as possible so that it's not overwhelming or intimidating to the caregiver. But here you're saying that it has to be thorough. It has to be detailed enough to then make sure it's, you know, up to par for all of the billing and authorization and full circle. So how do you how do you strike that balance of it being lean enough?
but also detailed enough at the same time.
Greg Bean (27:06.462)
So I think whatever you're using to manage, whether you're using a mobile app or whether you're using paper documentation or whatever that might be, it has to have all of those pieces and parts as like a checkoff of a yes done, yes done. You still can have all of those things in place, but when you're creating that plan, it has to have all of those pieces and parts associated with it. So yes, I did a shower. Yes, he used a walker. Yes, he used this. No, he didn't use this.
Those can still be done from a point by point part of the plan of care, but it has to be added so it's accessible. Instead of just, again, we've tried to make it so simple so that we don't have all kinds of stuff being created, but we've also created it to a point where now we're not actually being as thorough as we need to be for the care being provided for the veteran, which then goes back to all of a sudden the case manager on the VA gets there,
request for a reauthorization, which we'll get into here in a little bit. And it says we need 16 hours a week, but then everything that just shows is it shows that they went in once a day and gave a shower and left. That becomes less time than the four hours a day that they were thinking they were given, because it doesn't take four hours to give a shower.
Miriam Allred (28:24.398)
And verbiage matters here, correct? The verbiage of these tasks has to be verbatim to what the VA is looking for, is that correct? Or there is some wiggle room.
Greg Bean (28:39.068)
I think it needs to match up to the message that's coming across or the, I'm trying to think of the correct term here. I want it to be in the spirit of what we're providing. So does it have to say used a walker at this level or does it say ambulated with walker? Does it say, needed a shower chair or maximum assist with dressing versus
had to have hand over hand dressing. I think as long as you're going with the spirit of the message of what's being created at each level of care, the VA creates each one of these levels very specific and there is very specific verbiage within the VA's assessment. So as long as your messaging matches up to the spirit of those, it's going to come across correctly.
Miriam Allred (29:31.374)
Okay, yeah, I think of it like categories. There's basically the VA provides like the categories or the buckets, but then the actual notes that the caregiver inserts, those are up to their interpretation. But I like the word using like the spirit of what is taking place in the home within those established categories. You also mentioned a couple minutes ago about like scoring, there's actual scoring at play here. Can you explain that a little bit more of like what that scoring is and why it's important?
Greg Bean (29:59.048)
Yeah, it comes in under the assessment portion of what's going on. So if I were to pull up the scoring mechanism that's done in the assessment by the VA, it would tell you that needs assistance with dressing. And then inside of that, it might say, max assist with dressing, dress itself with minimal assistance, able to dress with this. And it might have four categories.
at different levels of care within that. Those are then scored like a zero, a one, a two, a three, depending upon their level of needed care. Shower, uses a shower chair, has to have a walker to get there, uses a wheelchair to get to the bathroom. Those things are scored. Feeding, feeding comes through and it says.
Do they need assistance in meal preparation? So on and so forth. If you get down to the point of where they need assistance with measure because of swallow, the VA actually has a little blip in there that says needs a swallow study. If you're at that level, you need a swallow study by speech to make sure that you're safe. Having each one of these things scored then comes into a number score at the back end. And that's what tells the VA how many hours of care a client gets by how they scored in their assessment. So the VA uses that assessment, creates a score,
and then dictates their hours of care around that score and level of service.
Miriam Allred (31:21.23)
So the score is for the VA. Do you think owner like the agency is thinking about that score and using that score? Because I guess I see a lot of value of like, obviously, the AI or the VA authorizes hours based off the score. Is that score meaningful or an indicator that the agency uses or should use or not necessarily?
Greg Bean (31:43.924)
I think what's really incredibly important from the agency standpoint is to make sure that when they document in their assessment and as we talked about care planning around that, that they've taken each of these levels within that assessment and they've addressed them specific to where they are because that then is going to go back to and give that score back to the VA without saying, they're a 27 or oh, they're a 52. We wanna make sure that we're addressing each one of those levels
within that thoroughly so that the VA then when they score it, they can say, look, he needs this much max assist. It's a five, it's a 10, it's a 12. So it allows them for secondary scoring and first scoring through to make sure that levels of care are supported by the needs of the client around activities of daily living.
Miriam Allred (32:34.004)
agencies giving the caregiver's transparency into these assessments? Because I'm thinking in my mind, sometimes the care plan is a an abbreviated version of the assessment. But I I'm kind of envisioning like a caregiver benefiting from understanding these scores and these numbers and what they mean, but also as almost motivation and fuel to help the client
progress like in their score, but really progress in their care. So I guess my question is, do you think agencies are giving enough transparency into the caregiver about all these assessment details, even to the level of scoring or not necessarily?
Greg Bean (33:14.324)
You know, I don't know that I would go to the level of scoring. I don't know that that's necessarily a requirement within it for caregivers. But do I think that the vision of the client's needs should be dictated to the caregiver and why we're doing it and why they're creating different levels and different check boxes rather than just check boxes? Absolutely. Because at the end of the day, most, and this is terrible, most I would say of our veterans become a.
custodial care type client. They have daily needs, they're going to be having these daily needs and they're going to have them for the rest of their life. We do have clients that we take care of post procedure that might've had a surgery that are gonna get better and they're gonna go on about their business and they're not gonna need care in a few months. But most of our clients fall under that realm of they're going to need this help for the rest of their life with assistance with activities of daily living. With that being said, making sure that we still show progression, you know,
Greg wasn't walking before, but now he's getting 16 hours a day, so he's walking. How important is it for us to actually show how amazing our care is helping? look, and we can talk about that when we talk about what we wanna manage and what we wanna measure later on in this conversation and why we would be measuring those things. I think it becomes incredibly important to measure some of these outcomes as we look towards advancing and creating higher levels of care for our clients.
Miriam Allred (34:40.524)
Yeah, we're definitely aligned on that. These caregivers know these clients better than almost anybody else, and they care about their well-being almost as much as anybody else. And so they want that progression. They want to see those numbers improved. And so you're right, maybe giving them the scores is too much, but just this concept of giving them a really comprehensive look.
And then also giving them a sense of where they are and then empowering the caregiver to help communicate and document that progress. And it's both like motivating and satisfying and, you know, helps the office understand and helps the VA understand, but just empowering the caregivers to understand the full picture here and understand where they're at and where they're, how they're progressing.
Greg Bean (35:28.126)
You know, it's really funny because, you I've worked for many agencies, both at a corporate level, but also as an individual. And one of the things, you know, and I know agencies don't like to hear that a client goes from agency to agency or whatever it may be, because sometimes, they might not like an administrator, they might be upset about something, and so they go somewhere else. But if you ever watch how many times the caregiver follows that client. So the loyalty to the client is amazing.
and the loyalty of the client to the caregiver is amazing. So we create relationships as agencies. In fact, that's one of the strengths of agencies is creating relationships with our caregivers and our clients that are life lasting. So when we do that and we provide that level of care, if we're encouraging and tailoring their needs within that, we're going to create a stronger bond. We're gonna create an everlasting bond that the agency, they're never gonna wanna go any place else.
because we've acknowledged those levels of care and we've created a caregiver and an opportunity. The other thing is, is it allows us to put the right caregiver in place for that client because caregivers are trained differently and their mindsets are different. And some people manage and work better with one client versus another. So tailoring that care plan and understanding what the high level of need is. Do they need a Hoyer lift or a slide board when they're doing a transfer? Does my caregiver...
comfortable with those levels of care? Are they comfortable with those needs? Have we done the right training? Have we put them in the right place to be successful? Assessment, care planning, all helps us to put the right people together so our clients have that everlasting bond with their caregivers.
Miriam Allred (37:08.814)
Yeah, 100%. Really well said, Greg. Let's shift gears a little bit and talk about the education piece. So think from the lens of an agency that's been credentialed, they've got the contract. How do they find the veterans and how do they get out in their market and educate their local population about the opportunity that is VA home care? How do they do that? What are the ways?
Greg Bean (37:33.374)
Yeah, there's a couple of different ways to do that. I always say you start with the acute care and then you just keep going down this path. So we're gonna talk, we're gonna do Greg's Marketing 101 here. And it's gonna be very abbreviated, but we're gonna get into this a little bit. So when I talk about, if a veteran's in network with the VA, meaning they have a service-connected disability or they're in network and they're up at your local hospital, they're at...
Miriam Allred (37:46.328)
Perfect.
Greg Bean (37:59.788)
a St. Luke's, a St. Mary's, or a Kaiser, or wherever they might be. The case managers and discharge planners at those hospitals have the ability to do what they call a peer-to-peer review and actually have a conversation with the VA and then send that veteran home with services and care. It's not a common practice.
It's not something that they know how to do or do very well because it's not something they do all the time. And a lot of times they aren't even asking if they're an in-network veteran or if they have a service-connected disability or if they even know these things. But this is a great opportunity for home care companies to actually be having conversations with hospitals that they're actually going to for their private pay client or their long-term care insurance client or whatever they're doing to discuss how this massively underserved population of veterans can be getting free care.
How can we do that? You can be doing a peer, teach them, educate these people on how to do a peer-to-peer review, and then walk them through the process. Now all of a sudden that same person's getting a care authorized from home rather than saying you have to get out of the hospital and be discharged and then go back to the VA and get seen by your VA doc. And now they never get care. They don't get started because they don't go back, because they never went to the VA hospital in the first place.
They went to their normal hospital they've been going to for years, not even realizing that they had the eligibility and the ability to go back through. So home care agencies have the ability to use this as a growth point, as a leverage point to help to teach and educate the acute care, even the acute rehab people, how to do that. And then I can talk with them about my caregivers, how they can help, like I talked about, with a slide board or a Hoyer lift or with swallow issues and all those things they can be discussing that their caregivers can do.
to bring these people home safe and sound and in a good place.
Miriam Allred (39:48.074)
Is this scenario the most common in that this is probably the biggest opportunity in the place that agencies should start, which is going to the hospital systems and educating their first?
Greg Bean (39:56.914)
Well, I think that again, my my two favorite referral sources from the home care world are acute rehab centers and skilled home care companies that aren't actually providing private duty services. Why? Because skilled home care companies are working under the Medicare platform. Many of them aren't even using a VA benefit. We just talked about the fact that all of these veterans that aren't using a VA benefit that are being seen by their Medicare or whatever it might be, but they could be getting a caregiver through the VA for free.
Or even if they're financially in a different place, they could have potentially a very small copay versus that $40 an hour caregiver under the private pay world. So if we can avoid that and we can help veterans to get it, I would use my wife as a great example. My wife is a home health nurse and she works in the home health space all the time and she sees seven to 10 to 12 veterans a week.
And one of the things she says about so many of these people is they can't afford personal care.
But what if that agency that we're talking about, know, Gregg's Home Care, could go out and have a conversation with that veteran and help them to show them how they can enroll in benefits, can talk to them about how if they're in the VA's network, they could see a VA physician and get care started. How much better are the outcomes for that client who's home-based, who, by the way, has to be home-bound to accomplish this? So we understand that that's, you know, that's a requirement for them. So again,
we now have the ability to have much better outcomes in the skilled home care world by having a free caregiver given back across. So skilled home care, massive opportunity to be educating these people who are not using their benefit, how to use it, and expanding their care.
Miriam Allred (41:50.574)
Okay. I'm loving this. I'm loving this Greg 101 because this is from your lens, which I think is really powerful. So acute rehab centers, skilled home care, those are two ripe opportunities. And like you're mentioning, they don't know a whole lot about this. So you're educating them so that they can educate their population. And then boom, you build a great referral source.
Greg Bean (42:01.139)
Yeah.
Greg Bean (42:10.982)
Absolutely, so it comes back through. You know, we talk about community organizations and you know, one of the things when we talk about the VA is that we immediately go the VFW or we go the American Legion. But how many people talk about the Elks Lodge or the Moose Lodge or the Masonic Lodge? I keep going on with lodges, right? I mean, as we have this conversation, we have a massive veteran older population associated around these organizations. How many of them know or have veterans in them that don't know
they could be getting free care.
You know, I did a presentation for a senior center last year and for one of our partners and there were like 25 people there at the senior center. And I went through and I explained to them how they can enroll, what the enrollment line is, how they can enroll for free, how easy it is that they can do their entire enrollment into VA benefits over the phone. I explained this to the family and I explained what their requirements were. And I said, how many of you in this room have a husband, a wife, a neighbor?
a son, a daughter, somebody else that lives in your building, whatever it might be, that could benefit from a free caregiver from the VA. 23 people, 23 people raised their hand. Every single one of them knew somebody that could benefit from this service if it was coming to them for free. So getting out into the community and doing these educational opportunities, you know, in my mind, it's not marketing at all.
It's education and advocacy. It's teaching and educating the people about how they can be getting a service and a care they don't realize is even available to them, and then walking them through the process, and then just providing an amazing caregiver on the back end to help them with support.
Miriam Allred (44:01.804)
Okay, imagine an owner, owners listening to this and they hear what you just said. They themselves are not an expert in this area. They themselves don't know enough about credentialing and authorization and all of these, all these logistics and details. Where can they go? What websites, what resources, how, where do home care owners need to go to become the resident expert in these areas?
Greg Bean (44:26.772)
It's one of the things I teach to our base every day. So where can they? I mean, I would say there aren't a lot of resources. There aren't a lot of places out there in the world, unfortunately. I do some training and education. I would say later this month, I'm actually doing a webinar specific to families and organizations on how to do enrollment and how to get those things in place. I think there are some opportunities and.
and would gladly share that with folks if they're interested in learning how to teach people how to get services and care. I think it's incredibly important as we advocate to get more people involved in the system that we share that information as we go forward.
Miriam Allred (45:10.734)
Cause I'm sure everyone that hears this saying you went to a facility, you know, on someone else's behalf a year ago. think everyone here is like, wait, I need Greg sitting by me to go out and have this presentation with the referrals and their own local market, because it's a lot of information and there's, there's a lot of regs and there's a lot to it. And so I think owners that have been doing this for a long time, like they've figured it out and they've learned the hard way and kind of done their own research.
But you're right, there's not a lot of information out there and that's why we're on this podcast and that's why we're talking about it. But I think to go out and actually do it is another thing. But I'm glad that you, AxisCare, other partners in this industry are putting out more information to help owners feel confident, become their own resident expert in their home care business to be able to go out and do this.
Greg Bean (45:55.538)
And I think the key here is, you know, I can't tell you how many times I've had nurses, you know, being a nurse myself for the past, I took my boards in 85, so we don't want to date ourself too much, but I've been a nurse for a really long time. But I have nurses tell me all the time I'm not a marketer. And I say, you must be a very crummy nurse. That's not usually how I say it, but I'm going to say crummy nurse. And they get offended. And I'm like, well, if you're providing really crummy care.
Miriam Allred (46:06.924)
Thank you.
Greg Bean (46:24.628)
And they're like, I'm the best nurse in the whole wide world. I said, then you're the best marketer in the whole wide world. So you're advocating for care and you're advocating for service. And I think for owners to understand that this isn't about going out in marketing. It isn't going out and selling anything. It's about how do I take my resources for veterans, for people in the community and go out and teach and educate and help the 10 plus million veterans over the age of 65 that aren't getting care, get care.
Miriam Allred (46:28.718)
Mm.
Greg Bean (46:55.794)
And if you can just put that into words to show people how they can be getting free services and care, then you've done your job. There's no marketing to it.
Miriam Allred (47:05.037)
I think that's a great opportunity here. Just thinking out loud that a lot of times the marketer, the business development rep, you know, is out there giving these presentations to referral partners, but bring the nurse with you. Bring, the nurses are busy granted, but bring the nurse out there with you to explain that assessment process, to explain the customized care planning process so that those partners, those people in the meeting can get a sense of the actual process that takes place.
from the nurse's perspective.
Greg Bean (47:36.564)
Another presentation that was done last year was with a home care company in a building having a conversation, large group of people, one of the people that got up and spoke and had a conversation following Greg. Now, Greg thought he was amazing until Susie, the most amazing caregiver in the whole wide world, stood up and talked about why she took care of Joe and everything she did for Joe and why she loved Joe. And guess who else spoke? Joe. About how amazing Susie was.
and how she provided care and why she provided care and how good the service was and everything about it. So let me just tell you, they signed a huge number of clients from this opportunity because it wasn't Greg's presentation on how you can enroll, which I like to think that I was pretty important in all those pieces, but the bottom line was, you know who people were like tuned into? Susie, the most amazing caregiver and Joe, the veteran who was getting care from Susie and why and how, those are impactful.
Use them. Incorporate your clients and your caregivers back into being proactive and managing those pieces.
Miriam Allred (48:44.954)
Love that so much. Not to shoot down the role of owners and administrators and the biz dev reps, but you're so right. Get the caregivers in these rooms, in these conversations, in these settings, get a VA client in that room to share their personal experience. What is more impactful and would resonate more than that? Having the client and the caregiver in that room to share their personal experience.
I hope everyone listening to this tries that, you know, of course it takes coordination and logistics and it might be easier said than done, but the outcome, like you just said, can result in more referrals, more opportunities to help more VA clients.
Greg Bean (49:24.852)
You know, one of the things I throw out there for tidbits and pieces when we're talking about marketing and marketing opportunities and sales, I ask companies over and over and over again, how many of you on your homepage or on your Facebook page or wherever it might be have a message from our veterans? How many of you weekly or monthly or whatever it might be? You know, I talked to a company not too long ago that had 107 veterans. I said, how many times on your Facebook page have you had a message from a veteran?
I said, literally you have 107 weeks worth of free advertising. Go out and talk to them. Do 15 seconds on why it's amazing and what they get. What is it they love about their caregiver? What is it they love about their company? What is it they love? And it's not about the company. The message should be about care and why. It shouldn't be about Greg's Home Care or any of those other folks out there. It should be about my caregiver, my care. I'm a veteran. This is what's amazing.
and they should have a weekly message. What they should do, how they should do it. Veterans are willing to share positive back to other veterans. And if they think they're giving it to other veterans, they're more than happy typically to jump in and give a message to help other vets. It's a closer network that way.
Miriam Allred (50:43.022)
Yeah, and think back to what we talked about at the beginning of the conversation of in that assessment, sometimes they have their guard up, sometimes they have those walls up, but these people are unique and special and their stories and their experiences are so special and unique. And so they want to hear from other veterans. They want to hear from other people like them and their experience because they can relate and they can empathize and they can see it from someone else's lens similar to theirs. So I think that's
Great, great advice. A lot of great insights, Greg. I didn't know we were getting a marketing lesson today, but I'm glad we threw this in here. Time is flying. I really want to get to the authorization piece. This is maybe the boring mundane part, but this is the reality that home care agencies are up against when it comes to managing authorizations. The question I want to ask and start with though is underutilized hours. So we talked about the scoring. We talked about a client is allotted so many hours.
Sometimes we see and hear that hours are underutilized. They're not maximizing all these hours. Why is that happening?
Greg Bean (51:45.844)
I think it goes back to a piece of educating the veteran as to, you know, the old adage, you use it or you lose it. But if the client doesn't need the hours, I don't think they should have them.
So I'm kind of of the advocacy that there are tens of thousands of veterans who need the hours, who aren't being given them and aren't being underutilized. They're actually using all they have and they don't have enough versus the veteran that's saying, I don't want them to come and I don't need them to come. I think the key here being is educating them as to why they're getting them.
what the assistance is for and how they're getting it. And if they really need it, they need to use it. If they don't need it, then I'm moving on. I'm actually passing back across to my case management team that they're not using them because they don't need them. And they really should be only using hours that they need. There's too many out there with needs that aren't getting them met versus the ones that aren't. I don't see a lot of under utilization that way. I think it's more a...
not having enough hours and it is actually under utilization of time.
Miriam Allred (53:01.354)
Okay, okay. That's good to hear you share that. This might be controversial, but in the case that there is underutilization, is it wrong for the agency to maximize those hours? Or I guess it just comes back to reassessment, reassessing the situation and the hours.
Greg Bean (53:17.812)
Well, and again, if the agency is assessing the client's needs and they need those hours, then they should be educating the client as to why they're trying to give them the hours, why they're doing this, because eventually you will lose that time. And it's okay to share that. Look, if you're just stubborn and don't want help with the bath, but you need it, if you're stubborn and don't want help with preparing a meal, but you need it,
if you're stubborn because of this, then you're eventually going to lose those services. And then if you really can't do it without some assistance, you're not going to have it. So understanding, it's okay to be point blank with the veteran and share with them. If you're just doing this because you're stubborn, but it's not because you need it, then step outside your comfort zone and here's why. And you can be very blunt and it's okay to be blunt and straightforward with them about what the opportunities are.
Miriam Allred (54:14.508)
Yeah, that was good. Okay, let's talk about authorizations. And before I ask some specific questions, let's, let's talk through the process of what happens. So a shift has taken place, the care is documented, everything's perfect. What what happens after that? Like, what is the process after the shift is completed?
Greg Bean (54:33.96)
Yeah, so let's go back to authorizations from the very beginning. So what happens with an authorization is the primary care for the physician, for the veteran, sends a referral up to case management at your local VA hospital. Every single authorization created within the VA is done with the community care case management team at the local VA hospital. The physician's not doing the off, no, it's all being done by case management. They then reach out to and do that assessment
on the client, do you need help with dressing? Do you need help with this? Do you need help with this? Do you need help with this? Then they score them, then they create an authorization for how many hours of care the client gets. That authorization then gets uploaded into the system, given to the home care company, and they get an authorization. We're gonna say it's 16 hours a week. We're gonna make it simple for my math purposes, all of the above. And they're going to say it's 16 hours a week. And then the client is going to be reached out to by the home care agency to say, you've got 16 hours a week.
We're gonna come four hours a day, four days a week. What days do you want them? However they're going to, then they work together to create that. That authorization is in the VA's system, which gets sent across to either TriWest or Optum who manage the payment. So the caregiver provides the care, they provide four hours a day, they do 16 hours a week. That bill then gets sent to either Optum and or TriWest that it says they're 16 hours of care.
As long as they don't do over 16 hours of care, they're gonna submit that bill, they get paid. It's quite simple. The problem becomes if they overdo their hours, they're going to get denied. And when they deny it, they don't deny the 15 minutes over, they deny that claim. So managing that number becomes incredibly important. That's why your automated systems, that's why your account management systems have the ability to set limits.
that you can't go over certain dates and times. The other thing is that the VA does their entire cycle, to Saturday for their billing week. So you have to realize that if you start your day on Monday, it doesn't go through to Sunday, because Sunday wraps into the next week. And if you just happen to run into that extra day being a Sunday, all of a sudden now you've done 20 hours for the week.
Greg Bean (56:59.55)
because it was part of that billing week for the VA, which is always Sunday to Saturday. So understand that's how you can manage your authorizations from that standpoint, making sure that your work week, your client scheduling week, matches up to the VA's billing week and that the hours match up. Now the real key to authorizations for me is making sure that you go back to that really thorough comprehensive assessment. Because when I got that authorization for 16 hours a week, but when my nurse went out and did the assessment,
Greg's bed bound. He can't get out of bed. He can't get a shower. He can't get a bath. He can't feed himself. can't, she then needs to take that assessment and go back to the VA and say, we need authorized more hours, but you have to have the documents to support that.
When I do my reauthorization, say Greg's up for reauthorization and so I don't miss it, I'm gonna set reminders in my system to tell me, in 60 days, Greg's authorization's gonna run out. In January, the VA moved to two different auth periods, either 60 days or 180 days. They used to be annualized auth, they're not annualized anymore, now they're every six months. So understanding staying on top of that because once your auth runs out, if you don't have a new one, you're not gonna get paid.
So creating those pieces and places of point. When you ask for reauthorizations, you're doing that through a form, an RFS form, having the assessment, the care notes to match the levels of care and all those when you're requesting care, all go back into your authorization process.
Miriam Allred (58:36.613)
Okay, that was amazing. That was I'm so glad you covered that. I mean, here we are almost at an hour and we're covering that. That was that was great though. And you identified a lot of the pitfalls here. One of them being the proper date and time that the window of which the claims are submitted. That's an easy pitfall right there. Limitations, people going over the authorized hours.
And making sure that there's a set of eyes on that before they get submitted because like you said, it's not just that time that's denied its actual claim that's denied, which is a huge pitfall. And then these reauthorizations to make sure I understood that right. Is reauthorizations established at the state level? It's different per state or that's universal.
Greg Bean (59:18.108)
It's universal and the reauthorization is created by the request is created by the agency. They get sent across to that case management team requesting an authorization. Now, the key to that is making sure that you have all your documentation correct, your care plans done, the notes match, because again, we'll go back to I'm requesting 16 hours a week for Greg going into the new year, you know, for my next off period. But the caregiver only did a bath once a day.
for the four hours they were there, that's all they did. Or they didn't do a bath at all, or they didn't do a shower, or they didn't help feed them. Then when that case management goes to reauthorize that level of care, they're gonna say, well, your documentation doesn't match up to what you're saying you have needs for your client. And your assessment isn't matching up to what your needs are for the client.
Miriam Allred (01:00:08.142)
Which is why the documentation is the foundation here and you have to get that right or it's all a nightmare down the road. You said from the very beginning, you said that the agency submits or applies for that reauthorization. Can they do that as many times and whenever they want or are there limitations there?
Greg Bean (01:00:14.462)
from the very beginning.
Greg Bean (01:00:26.782)
They can do a request for services anytime there's a change in the client's condition. Say they go out and do an assessment and they evaluate Greg and Greg's actually had an increase in needs and their assessment shows the increase in needs. They can create an RF request for services form at that point in time, put the assessment, put the appropriate documentation together with that, and they get back across to case management and request increase in hours.
according to the level of needs of the client. And then on top of that, the client can reach out directly to their case manager and say, I need more help because of this. But then educating the client as to what all these things are then goes back to, my daughter's calling and saying he needs more help with bathing. He needs more help with dressing. He needs more help with feeding versus my dad needs more help.
Miriam Allred (01:00:57.742)
Okay. Okay.
Miriam Allred (01:01:17.644)
Yes. Okay. I want to ask you this managing authorizations is and can be a lot of work. Where does the technology thrive? What can you rely on the technology to do best? And where should the humans, where should the office staff, where should the team focus their efforts? Like what does technology do best here? And where does technology waiver and where does the human focus need to be on when it comes to managing authorizations?
Greg Bean (01:01:46.996)
So I think the real key is how can we, from an automated standpoint, take that authorization information, add it into my account management system, whether that's automated or whether it's manually placing it into place, and then set parameters around that authorization for my scheduling and so on and so forth to where I can automatically eliminate overages and underages, and I can also track what the overages and underages are because I've created an authorization specific to my
plan of care into someone which is now automated alongside of my schedule. So if I'm doing it with pen and paper, it's hard to manage 16 hours to 16 hours. But if I'm doing it in a SaaS product where it says I've done 16 hours and I can't go over and the scheduler who we're all human goes in to say, I want to give Greg four more hours. It's like, oops, I can't because I've used them all. I think that becomes incredibly important. So then making sure that those
automizations, either the automization of pushing the auth in by itself automatically, or whether you're human upload and it's corrected, and then setting parameters for when you're doing your re-auths and what your knowledge is. All these things can be done through an automated system versus going in and saying, oops, I made a mistake. I didn't see this one was running out. You have to set those parameters in place so you know you're checking. And if you're doing it manually, you have to have
you know, something in your brain, something on your calendar, something in your outlook, someplace has got to tell you, I have to go check these auths, or it has to be created into your platform to where it automates that.
Miriam Allred (01:03:24.334)
Yes, I don't want to embarrass you with this comment, but you're using this word, automization, which I don't think is a real word, but it's automating authorizations, which I think might be maybe you need to like coin that term for yourself. Automating authorizations, automizations, like that's what home care agencies are doing. They need to automate the authorizations. Okay, that was so good. And there's more we could dive into, but I think that was a really good high level overview of
Greg Bean (01:03:42.612)
There you go.
Toss me under the bus, it's okay. I'm good with it.
Miriam Allred (01:03:54.83)
how the authorizations work, common pitfalls there, where technology thrives, where the humans need to supplement that. Earlier you mentioned like KPI. So let's talk about like long-term managing of authorizations and VA clients. What are some of the KPIs? What are some of the metrics that agencies should have their eye on when it comes to VA cases specifically?
Greg Bean (01:04:17.65)
Yeah, so I think it's incredibly important to usage. You you talked about under usage or not usage and making sure that, you know, if I have 100 authorized hours for clients, I should be making sure that I'm using 100 hours. If I'm not, why? Is it because they don't need them? Is it because the author should be changed? Is it because we are not scheduling enough care for those clients? So we should be tracking diligently the amount of authorized hours versus actual hours supported.
We need to be tracking and making sure that our care meets the level of our clients. And if it's not, that our documentation around that supports requesting more hours within our reauthorization process. So documentation becomes so incredibly important there. So that allows us for an uplift of our potential hours. Or if someone gets hours cut because I documented correctly, I can be going back and appealing that to get more hours. Outcomes become incredibly important.
What are my outcomes? If I can go back and show statistically and consistently that my clients that are getting 16 hours a week aren't getting re-hospitalized, but those that are getting six hours a week are going back to the doctor frequently, if I can show that, I can have that conversation as we move forward on a much grander scale than maybe my local agency. But we have to be able to monitor and manage these things long-term to make sure that we're doing them correctly. If I was looking at specific KPIs,
I'd say I've got my documentation, my usage of hours, my reauthorization's timely, what are my dates created, so on, and then what are my assessments creating? Are they creating more hours? Are they creating less hours? Are they actually showing an increase in hours? Because I've done them thoroughly, and if I'm not doing them thoroughly, do I need to do a better job?
Miriam Allred (01:06:08.526)
Wow. Okay. That was good. That's going to be a relistened section to go through all of that one more time. You have worked with so many agencies nationwide when it comes to helping them scale and grow their VA business. Can you think of just one example of an agency that was so successful in this? really
nailed all of these things that we've talked about today and then they, I don't know, double or triple their VA clientele because of their mastery of this. Any specific agencies coming to mind of just a success story that you could share.
Greg Bean (01:06:41.94)
You know, I think one of the things I would say that jumps out at me is an Illinois office that came to me several years ago and they got credentialed and they wanted to start care and they're like, where do we go first? And they had a hundred plus private pay clients that they were already working with. And I was like, well, how many of your private pay clients, if you help them to understand and what them qualified for services could be getting care and service, it would now be free.
or it could add to their client number base or assist them with care, so on and so forth. They converted 12 of their current clients into VA clients. They then used this understanding of that benefit to go out into their community and educate and advocate and create. And within the first year, they'd gone from zero to 56. And I can tell you within the first two years, they outnumbered their private pay clients with their VA clients by getting out into the community.
educating them on the opportunities, showing them how to get the benefits, and then actually moving forward with providing that service and care.
Miriam Allred (01:07:47.886)
Perfect example, perfect example. Like you just said, identifying your VA opportunities with your private pay clients, using that as kind of a testing ground, getting all those testimonials and reviews and get that process underway with those clients. And then that is how you scale.
Greg Bean (01:08:08.017)
Absolutely.
Miriam Allred (01:08:09.666)
Greg, this has been awesome. We have covered a lot of ground. I have more questions, but I feel like that was so good. I know you have notes in front of you. Is there anything else that we didn't talk about or anything that you haven't said that you want to make sure we cover here towards the end?
Greg Bean (01:08:26.43)
No, I think the only thing that I would say over and over and over again is it's every single person, not just listening to this podcast, but in this country to make sure we're stepping out and making sure that veterans get the care they deserve and need, and we educate them across the country.
Miriam Allred (01:08:43.662)
That's the call to action and that's what we're going to do. And you are a champion, Greg, of this effort in helping these VA people, these military people, these families in this country get the care that they need and deserve. And I just, think so highly of you and everyone that's on this mission to help these families. Again, serving any and all senior
clients in this country is amazing, but there's just this ripe opportunity to help these people that have served our country and they deserve the best.
Greg Bean (01:09:16.382)
Thank you.
Miriam Allred (01:09:18.304)
Okay, Greg, I think we're gonna end there. Just last question, last thing here. You mentioned some upcoming webinars and conferences and things that you're going to be speaking at. We'll make sure we drop those in the show notes so people have access to those because like we talked about, it's all about education and...
We want to help educate the home care agency owners, operators so that they can go and educate their population. So we will. So I'm just calling that out. We'll make sure we drop those things in the show notes. And this won't be the last time you hear from Greg and I, I've got a lot more questions up my sleeve. And so this is probably just part one of what will be more to come. So Greg, thank you so much for joining me in the lab. Great session today, and we'll look forward to more again soon.
Greg Bean (01:09:57.716)
Thanks, Miriam.