Inadequate contract reimbursement for expensive items
Randy McFarland
Description
Collection
Title:
Inadequate contract reimbursement for expensive items
Creator:
Randy McFarland
Date:
8/18/2005
Text:
Hi List members,
What do you do when a physician specifies a particular brand/model of
a more expensive off the shelf device that costs you about the same as
what the contracted reimbursement will be? (The manufacturer even
recommends the L code with the inadequate fee.) I'm finding this is
happening more often, and with a contract, we can't ask the patients to
pay.
The options I can think of are:
1. Try to talk the doc into another model that will do the same
thing and costs less.
2. Create carve outs in your future contracts or negotiate better
reimbursements for such procedures
Can you think of other ideas? I'll share with the list.
Randy McFarland
Fullerton, CA
What do you do when a physician specifies a particular brand/model of
a more expensive off the shelf device that costs you about the same as
what the contracted reimbursement will be? (The manufacturer even
recommends the L code with the inadequate fee.) I'm finding this is
happening more often, and with a contract, we can't ask the patients to
pay.
The options I can think of are:
1. Try to talk the doc into another model that will do the same
thing and costs less.
2. Create carve outs in your future contracts or negotiate better
reimbursements for such procedures
Can you think of other ideas? I'll share with the list.
Randy McFarland
Fullerton, CA
Citation
Randy McFarland, “Inadequate contract reimbursement for expensive items,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 5, 2024, https://library.drfop.org/items/show/225271.
