PMSI - Replies

PMSI - Replies

Randall McFarland, CPO

Before we terminated our contract with OPNET, we would sometimes fit
orthoses onbehalf of PMSI. Both before and after we had the contract, we
heard that PMSI had arranged for someone to mail the patients prefab.
chairbacks and corsets. We've heard stories about some patients being
called by a representative of PMSI and asked their waist size and then mailed
corsets to them without any instructions being included. Just today, we had
to run out to the hospital O.R. to provide a cervical orthosis for a Workers
comp./PMSI post surgical patient. PMSI had mailed the wrong type to the
patient just before his surgery. I want to determine if this is a common
problem or just bad luck in our area.

Here's my original post:
Does anyone know anything about a provider company called PMSI?
I understand they're based in Florida and  when they get an order for
orthotic services, they will ship the orthosis directly to the patient. Do I
understand correctly that California's Workman's Comp. is contacted with them?
Randy McFarland, CPO


Responses: Thanks to those who did!
       PMSI, a division of Bergen Brunswig, acts as a clearing house for all
the ancillary services a work comp claimant would need; prescriptions, rehab
equipment, home health, DME, O&P, etc.  They are based in Tampa but provide
services throughout the US. Most of their services, including O&P, are
provided through a network of providers, Hanger being one of them. Some DME,
however, such as TENS or off-the-shelf orthotics may be shipped from their
warehouse. Obviously, anything that is custom would be provided by their
contracted provider.
       They work with many of the carriers in California. You had asked if
they contracted with California Workers Comp. I assume you mean the State
Compensation Insurance Fund which is the State Fund which handles a portion
of California's comp market. PMSI does have a relationship with SCIF as does
Medical Services Company (MSC) which is company very similar in structure to
PMSI.

I know that a few years ago they were totally involved with Work. Comp. It
worked like this. . . .
An individual would get hurt on the job.  The employer would contact the
insurance company.  The insurance company would contact P.M.S.I., who would
then provide everything the patient needed, including drugs, nursing, D.M.E.,
and orthotics and/or prosthetic (my job).  I would then choose an O&P
facility near the patient's home and arrange for the service.I know of no
contract with Cal. Work. Comp. and it is very unusual for them to ship
directly to the patient, although that may have changed. 

PMSI (Prescription Management Services, Inc.) is indeed located in Tampa
Florida. Their phone number is 800-237-7676 and Fax 813-623-5785.
     In all of our dealings with PMSI they have acted only as a
review/authorizing agent for various work comp related services. It is
noteworthy to mention that recently our contract with PMSI has been
superseded by OPNET.
The authorization process is fairly straight forward, and they tend to fall
at the low end of the reimbursement schedule.

PMSI is an administrator for various worker's
compensation companies in a number of states. They
used to be called Oharmacy Management Services, Inc.
     I believe that they contract with O&P providers across
the country and refer patients in those specific areas
to companies with whom they are contracted. I don't
know about them direct shipping orthoses. I haven't
ever heard of that, but I have been with companies who
were cointracted with PMSI. As I recall, their
reimbursement rates are really low.

We are contracted in GA with them and we provide the service directly.  No
mail order.  They contract with many different WC insurers to get the best
deal.  They are not bad to deal with.

I am see alot of PSMI clients. Opnet has a contract with them. I have never
been asked to mail anthing to a client. They has a DME contract provider or
inventory some soft goods that they mail .