Wording of disclaimer: responses

Wording of disclaimer: responses

My original post:
As practitioners know, our fees are primarily compensation for our time and
expertise, more so than the components we use for our clients. There are
exceptions, like the high tech prosthetic knees and feet and myoelectric
prostheses.

I'm sure every practitioner has come across the client who expects a refund
if their perceived result is not what they expected in their mind. Despite
success with other clients and countless time and effort, there are some
clients that seem to have a problem with their perceived results everywhere
they go. I have seen this snare with a couple post polio clients where an old
KAFO needs to be replaced.

I tell my clients that I will make every attempt to meet their needs, and
that whatever I do will fit and function as intended, but I warn them that
there is a possibility that the final result may not meet the expectation
they have in their mind... it may not feel exactly how they expected. My
fee is for my time.

Has anyone come up with a succinct way to word this in an authorization to
treat document for the client's signature?

I will post responses. Let me know if you don't want me to include your name
when I post your response.

Thank you,

Randy McFarland, CPO
Riverside, CA

(I want to be upfront with the client so as to not give false hopes or
unrealistic expectations)

The responses:

good thought Randy- I look forward to the answers you get. I have run into
the same problem- particularly with new amputees, even more particularly with
AK amputees- their expectations are extremely high and the reality of walking
in a prosthesis- (even more so when they have complicated medical histories
and problems that led them there)- is like hitting a brick wall for them.
That reality gets transfered in blame, anger and frustration to the
practitioner then they don't want to pay you for it, or you are terrible at
what you do. Thanks for asking the question.
Jerry Nelson CPO
Ogden Orthotics Prosthetics Inc
Ogden, UT

   *YOU* have hit upon a nerve...that's for sure. Some patients
expect us to be like Walmart and take something back that is not
what they wanted. The way I handle it, particularily if it is a
custom Orthosis, is that we weill STILL bill for the item, and
attempt to recitify the situation with another device of like
properties. This works some of the time. Others, well, a refund
might be in order if they can't be satisfied. It's a case by case
assessment. CO

<< As practitioners know, our fees are primarily compensation for our time
and expertise >>
That's our opinion, but not necessarily shared by the end user or those in
the reimbursement side of healthcare i.e.: HCFA, Medicare, and etc. Al

An interesting question...I look forward to the replies. I have
occasionally(about 3 times) in 17 years in private practice refunded the
money to the insurance company. I call it a very expensive lesson because I
can look back on the client and see all the signs leading up to the problem.
Afterwards though, you understand. I give away a fair amount of my time but
there are instances where I can see a potential problem and would like to
have a beforehand understanding with the person before I begin any
treatment. Molly Pitcher, C.P.O.

My understanding is that we are paid for a product - the specific L-Codes
we are providing. If a person is self-pay, you can bill under different
terms,
but if they have any other payment source, particularly government source, I
don't think you could claim to be billing for your time. Putting that idea in
writing may cause you more problems down the road. You may still have grounds
for claiming that you deserve payment even if the device does not meet
expectations, but your reasoning would have be along the lines that the device
was manufactured and fit according to accepted industry and medical practice
guidelines, and would need to be backed by good (no - great) documentation.
      We all fight this, and it usually comes down to taking the loss on one
AFO or
prosthesis, rather than loosing much more in reputation, bad press, etc. I
got
some perspective on this when I heard an attorney say that people have to be
able
to claim injury or loss when they sue. My interpretation is that if the
device
has not hurt them, and they are not made to pay for something they don't want,
you stand less chance of getting sued, since there has been no loss.
John T. Brinkmann, CPO