Fw: Re: Re: [OANDP-L] Part 1-Responses to coding dilemma
Michael P Madden
Description
Collection
Title:
Fw: Re: Re: [OANDP-L] Part 1-Responses to coding dilemma
Creator:
Michael P Madden
Date:
4/10/2002
Text:
Another response? or defense?
MY ORIGINAL REPLY:
>
>It's easy, they are providing the orthosis (not the service) for
>significant discounts. They will charge only the base code fee, and
>that at below medicare prices (they have no overhead...ie office, staff)
>sometimes having the Dr's office bill the brace in conjunction with
>office visit and other medical charges.
>
>Workers comp. quoted me a price that they said they could get the same
>item for from a supplier, at what turned out to be 45% below the
Medicare
>fee...ouch!!!!!!!!!!!!!!
>
>Mike
Mike,
I would have to disagree with you when you say that the rep is providing
the orthosis, not the service. I think it is the opposite. The rep is
supplying the service, the product is secondary. Both you and the rep
can provide the product, why aren't you providing the service?
You are also speaking of a very different scenario when you say the the
Doctor's office is billing the brace. In this instance, the doctor's
office is your competitor, not the rep.
In regards to base coding, how can you bill for add-on codes for a brace
that you do not add anything on to?
This adding on of charges is why you don't have the doctor's business.
He is under the impression, mostly false, but at times true, that O&P
charges high prices. When, as we both know, these prices are set by
Medicare.
What was the item that workers comp got quoted 45% below Medicare?
I am not sure I understand the discounts that you talk about. If the
rep is billing below the fee schedule he is either stupid or doesn't know
any better.
I have made these statements on assumptions with little knowledge of the
facts of this case, please correct me if I am wrong.
###########
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MY ORIGINAL REPLY:
>
>It's easy, they are providing the orthosis (not the service) for
>significant discounts. They will charge only the base code fee, and
>that at below medicare prices (they have no overhead...ie office, staff)
>sometimes having the Dr's office bill the brace in conjunction with
>office visit and other medical charges.
>
>Workers comp. quoted me a price that they said they could get the same
>item for from a supplier, at what turned out to be 45% below the
Medicare
>fee...ouch!!!!!!!!!!!!!!
>
>Mike
Mike,
I would have to disagree with you when you say that the rep is providing
the orthosis, not the service. I think it is the opposite. The rep is
supplying the service, the product is secondary. Both you and the rep
can provide the product, why aren't you providing the service?
You are also speaking of a very different scenario when you say the the
Doctor's office is billing the brace. In this instance, the doctor's
office is your competitor, not the rep.
In regards to base coding, how can you bill for add-on codes for a brace
that you do not add anything on to?
This adding on of charges is why you don't have the doctor's business.
He is under the impression, mostly false, but at times true, that O&P
charges high prices. When, as we both know, these prices are set by
Medicare.
What was the item that workers comp got quoted 45% below Medicare?
I am not sure I understand the discounts that you talk about. If the
rep is billing below the fee schedule he is either stupid or doesn't know
any better.
I have made these statements on assumptions with little knowledge of the
facts of this case, please correct me if I am wrong.
###########
________________________________________________________________
GET INTERNET ACCESS FROM JUNO!
Juno offers FREE or PREMIUM Internet access for less!
Join Juno today! For your FREE software, visit:
<URL Redacted>.
Citation
Michael P Madden, “Fw: Re: Re: [OANDP-L] Part 1-Responses to coding dilemma,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 8, 2024, https://library.drfop.org/items/show/218801.
