another billing issue

Joe

Description

Title:

another billing issue

Creator:

Joe

Date:

5/20/2000

Text:

A doctor ordered a TLSO body jacket, we fit and delivered post surgery.
Medicare denied payment because the device is same or similar to a
device she received within the last 5 years. The patient received a
corset so she says, and it was not through our company.
What may have happened: She received a corset but Medicare was billed
for a TLSO(this is a problem in Los Angeles); She received a TLSO and
lied when asked if she received a TLSO before; our office did not ask
her if she received a TLSO as she lay in the hospital bed in pain;
Medicare personnel that review the claims can't tell the difference
between a corset and a custom TLSO body jacket; corsets support the
spine equally as well as a TLSO body jacket and I failed to see the
difference and no one bothered to tell me; O&P businesses are expected
to provide free service to Medicare patients. Any comments?

Joe

                          

Citation

Joe, “another billing issue,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 7, 2024, https://library.drfop.org/items/show/214023.