Bypassing Orthotists

Bypassing Orthotists

Monroe Prosthetics & Orthotics

2/17/2006

Recently I posted a note suggesting that some suppliers might be involved in fraudulent billing practices for accepting payment at below the Medicare allowables. Of course, I understand that this would be true only if these same suppliers were accepting payment from Medicare at the Medicare allowable rate for the same region of service. I'm sure this activity would never occur. For if it did, I would hope that a profesional organization (like ours for instance) might step up and call them on the indiscretion rather than sit complacently by while patients are denied their right to the full scope of service and idly watch the encroachement from less qualified providers who may gain a market advantage by such indiscriminate billing practices, reducing the service package rendered as required by law (for medicare clients) or incorporating additional billing methods into that service package. No, these things could never happen. I'm sure all is right in the world. I'll go back to the lab now and work on another gristle filled project and wistfully dream of the gravy.
Oh, yae... Check out the latest 2006 CPT code changes: CPT code 97760: orthotic management and training. According to CPT Changes 2006; An Insiders View, Orthotic management includes assessing the Pt:determining the most appropriate orthotic; and designing, selecting and fabricating the orthotic. CPT code 97762: Checkout for orthotic and prosthetic use... There goes another wave on this castle of sand. Maybe instead of chewing some more gristle I should disregard what I believe to be profesional provider standards and simply become a sales whore myself.
Robert P. Agard CPO