Re: Coding dilemma?
The Kogans
Description
Collection
Title:
Re: Coding dilemma?
Creator:
The Kogans
Date:
3/29/2002
Text:
> A side line wrench in the works is that the local CTi rep, & local Don
> Joy rep, were allowed by one of the insurance companies to provide the
> orthosis for just the base code price, thus receiving referrals from
> the insurance company. I know this to be true because the insurance
> company questioned my use of add-on's with my orthosis because the reps
> only bill at base code prices, so why should we have patients go to
> you.(and they specifically mentioned DJ & CTi, and our local GII guy
> told me he turned their offer down !!)
Questions to bring forth to the insurance company:
1) Are the reps certified/licensed practitioners?
2) Do they carry malpractice insurance?
3) Medicare requires providers of orthoses/prostheses to have an on-site
visit. Where is their site? Has it been approved?
4) What is their educational level? Have they received a degree in the
pathologies necessary to adequately treat the patient?
5) Why doesn't the insurance company just stock up directly from the
manufacturer and mail the items to the patients? It would be just as cheap
with about as good a service!!
-Mike Kogan, CP
> Joy rep, were allowed by one of the insurance companies to provide the
> orthosis for just the base code price, thus receiving referrals from
> the insurance company. I know this to be true because the insurance
> company questioned my use of add-on's with my orthosis because the reps
> only bill at base code prices, so why should we have patients go to
> you.(and they specifically mentioned DJ & CTi, and our local GII guy
> told me he turned their offer down !!)
Questions to bring forth to the insurance company:
1) Are the reps certified/licensed practitioners?
2) Do they carry malpractice insurance?
3) Medicare requires providers of orthoses/prostheses to have an on-site
visit. Where is their site? Has it been approved?
4) What is their educational level? Have they received a degree in the
pathologies necessary to adequately treat the patient?
5) Why doesn't the insurance company just stock up directly from the
manufacturer and mail the items to the patients? It would be just as cheap
with about as good a service!!
-Mike Kogan, CP
Citation
The Kogans, “Re: Coding dilemma?,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 27, 2024, https://library.drfop.org/items/show/218524.
