Re: Bypassing Orthotists
Todd Griffin
Description
Collection
Title:
Re: Bypassing Orthotists
Creator:
Todd Griffin
Date:
2/9/2006
Text:
Maybe my logic is flawed, but if the government will pay them for the items
(not to mention all the other insurance companies), it seems that apparently
it is perfectly legal for them to provide these products. I'll be the first
to admit that eliminating your competition via legislation would be ideal
for your industry, it might not be ideal for the American consumer.
Your industry needs to grasp the concept that you are an allied health
provider, and that there is always some overlap between different allied
health specialties. PT's, OT's, ATC's, pharmacists, HME's etc., etc., all
have a role in the DMEPOS world. You can't just say it's your world and you
are taking your ball and going home if everyone else doesn't play by your
rules.
The bottom line is this: none of these providers, O&P included, can get
reimbursed by any insurance company without a doctor's prescription. Ninety
percent of the time, the doctor's suggestion determines where a patient gets
their product. (Nine percent of the time it's the insurance company, but
that's a whole other problem.) Your industry needs to be marketing to and
educating your referring physician base, making them understand why their
patients would be better served by getting their products from you rather
than directly from the manufacturer or from the pharmacy downstairs. THAT
is the only way you are going to increase your market share!
Todd Griffin
Atlanta, GA
Former ATC, sales rep, distributor, DME provider, etc., etc., etc.
.................................................
-----Original Message-----
From: Joyce Perrone
EBI, Donjoy, Marquis -- all have put items on patients using
non-certified orthotists. This has been going on for a very long time.
And not just low-level devices (stock and bill) but more complex items,
as well. Donjoy in Pittsburgh has been great with working together with
the orthotist community, but I've not seen as great an effort
Nationally. As long as they can bill Medicare, and every other provider
out there, I'm sure they will do this. My question to the group - WILL
LICENSURE HELP THIS??? For those of you in states that have licensure -
has it helped you and HOW has it helped?? I think it is important for
everyone to have a clear understanding of this and if it is of help,
then to get on the bandwagon and pay to get licensure in your state. We
do not have it yet - and I am curious as what those of you with it have
experienced.
(not to mention all the other insurance companies), it seems that apparently
it is perfectly legal for them to provide these products. I'll be the first
to admit that eliminating your competition via legislation would be ideal
for your industry, it might not be ideal for the American consumer.
Your industry needs to grasp the concept that you are an allied health
provider, and that there is always some overlap between different allied
health specialties. PT's, OT's, ATC's, pharmacists, HME's etc., etc., all
have a role in the DMEPOS world. You can't just say it's your world and you
are taking your ball and going home if everyone else doesn't play by your
rules.
The bottom line is this: none of these providers, O&P included, can get
reimbursed by any insurance company without a doctor's prescription. Ninety
percent of the time, the doctor's suggestion determines where a patient gets
their product. (Nine percent of the time it's the insurance company, but
that's a whole other problem.) Your industry needs to be marketing to and
educating your referring physician base, making them understand why their
patients would be better served by getting their products from you rather
than directly from the manufacturer or from the pharmacy downstairs. THAT
is the only way you are going to increase your market share!
Todd Griffin
Atlanta, GA
Former ATC, sales rep, distributor, DME provider, etc., etc., etc.
.................................................
-----Original Message-----
From: Joyce Perrone
EBI, Donjoy, Marquis -- all have put items on patients using
non-certified orthotists. This has been going on for a very long time.
And not just low-level devices (stock and bill) but more complex items,
as well. Donjoy in Pittsburgh has been great with working together with
the orthotist community, but I've not seen as great an effort
Nationally. As long as they can bill Medicare, and every other provider
out there, I'm sure they will do this. My question to the group - WILL
LICENSURE HELP THIS??? For those of you in states that have licensure -
has it helped you and HOW has it helped?? I think it is important for
everyone to have a clear understanding of this and if it is of help,
then to get on the bandwagon and pay to get licensure in your state. We
do not have it yet - and I am curious as what those of you with it have
experienced.
Citation
Todd Griffin, “Re: Bypassing Orthotists,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/226154.
