Hospital billing, part2

Hospital billing, part2

Steven L. Fries, L.C.P.O.

Steven,
   If this were to happen to me, in my neck of the woods, I would contact
AOPA, obtaining  the appropriate information on the law addressing this
issue. Loaded with such, I would report back to the hospital in question to
see what their next move might be. I truly believe they (the hospital in
question) are asking you to provide O and P services illegally.
 Bill DeToro,CO

Steve:
     Under certain circumstances Medicare will allow billing for O&P items
during
the last two days of a patient's in-hospital stay or Part A SNF stay.  You
can find the directive that Medicare sent out on this on the AOPA web site
under www.aopanet.org.  Look under Reimbursement, then select
Reimbursement Policies/Information and select Pre-Discharge Delivery of
DMEPOS.
     This regulation, which should be used with some discretion, does not
technically apply to private payors, however some may be following Medicare
guidelines.
Kathy Dodson
Director of Reimbursement Services

Dear Steven:
  I am no expert on Medicare billing, but I do beleive that the two day
rule only applies to prosthetic appliances. Any orthotic device deliverd in
the hospital under Medicare is billable to the hospital. Items delivered to
private insurance patients in the hospital are billed to the insurance
company and not the responsability of the hospital, even though they may have
put them on a purchase order in the past. As for weekend emergencies, ask
your HMO or ins. co. for the pager of the on call nurse in charge of these
emergencies, they do exist. Medicaid patients in my state are always billed
directly to Medicaid. As far as the doctors are concerned they only want
their patient treated, don't expect them to fight the hospital for you,and
they will not care how or if you are paid. Please send me a copy of your
other responses so I can be further enlightend. Thank you.
Sincerely:
Ronald E. Cahill CPO

Get it in writing and show it to Medicare.  I believe it is unlawful.
Bob Brown, Sr., CPO, FAAOP

Steve,
   That is considered fraud, you need to call the national office and get the
medicare rules. We had the same situation and we provided the hospital
purchasing dep. with medicare guidelines which clearly state the hospital
will purchase the items or they will lose their medicare reimbursement!!
Luckhardt  C.P.O.

Thats spelled FRAUD, plain and simple..........
I've seen it in different areas and it is getting worse, run don't walk away
from this type of relationship and tell the Medicare people names, places and
dates on their fraud line.
Bob Bangham, C.O., L.O.