Re: "A" Code Responses

Re: "A" Code Responses

Mark Bondurant, CPO

Thank you for the compendium of results. One response in particular got my
attention, in the discussion of how to handle substandard reimbursement.

In Medicare, as in any other insurance, the only party that has any power is
the beneficiary. The only pressure that can be brought to bear on any
reimbursement situation is that brought by the beneficiary, your patient. If
you are accepting what Medicare allows for comprehensive foot care for your
patients, you are giving tacit approval to their reimbursement levels,
essentially saying these poor reimbursements are okay with you.

We can not be required to do things which are obviously detrimental to our
business (unless we have committed to a contract which is detrimental...).
Therefore we have a choice of whether or not to accept reimbursement which
does not even cover a substantial portion of our direct costs. This is why
most facilities I have encountered require payment in full for foot care, and
give the responsibility of seeking reimbursement for services to the patient.


I also recognize the frustrating feeling this gives the practitioner, who
wants the freedom to easily provide badly needed services, as I feel this way
myself. But I also recognize that to continue to practice, I need to make
those decisions which support a healthy business. (If I am struggling in
business, I am not much good to my patients)

I encourage all practitioners who are struggling with this foot care
reimbursement issue to consider this, construct their care plans accordingly,
and take a deep breath and have the patience to let the system work and bring
reimbursements to appropriate levels.

A special thanks to all who are working to affect change of reimbursement
directly.

Mark Bondurant CPO