Re: Janice, please read -- Fwd: [OANDP-L] New games from insurance companies

Re: Janice, please read -- Fwd: [OANDP-L] New games from insurance companies

Janice T

1/23/2019

Hello everyone, Medicare is doing a same and similar, in other words if your patient had an lace up brace, boot, night splint etc in last 5 years it's being considered to be same and similar. Sounds like commercial plans are jumping on board to.
Hope this information helps..

Thank you,
Have a great day!


Janice T

Accounting,

Beyond Prosthetics,Inc

15899 Los Gatos Almaden Rd Suite 7

Los Gatos, Ca 95032

408-356-6300

408-356-3215 fax

________________________________
From: <Email Address Redacted> < <Email Address Redacted> >
Sent: Wednesday, January 23, 2019 7:57 AM
To: <Email Address Redacted>
Subject: Janice, please read -- Fwd: [OANDP-L] New games from insurance companies




-----Original Message-----
From: Allen Dolberry < <Email Address Redacted> >
To: OANDP-L < <Email Address Redacted> >
Sent: Mon, Jan 21, 2019 1:55 pm
Subject: [OANDP-L] New games from insurance companies

Colleagues, we have run into a new issue with insurance companies,
particularly from BCBS and Humana. It seems that they disallowing multiple
braces, regardless of area or side, per day. There has also been addition
codes that have been denied too many per day. Also there has been similar
games where only 4 prosthetic socks, where 9 have been delivered, are
allowed per day. The insurance folks are claiming they are doing this
according to CMS guidelines.
I am wondering what others are doing to combat this. I appreciate you
feedback.

--
*Allen Dolberry CPO*