Max Units Responses
Andrea Couture
Description
Collection
Title:
Max Units Responses
Creator:
Andrea Couture
Date:
1/16/2008
Text:
Thank you to everyone who responded to my post requesting info on how they
handle the max units per DOS/year limitations insurance carriers have set up
- Here are the responses:
1) Have not encountered this particular situation, but, there are insurance
that limits the number of socks per year - indicating that they are
disposable items and a predetermined number is what they have arrived at as
reasonable. Our approach is educative -- that is to explain to various
levels of staff at the ins co exactly what an amputee requires on a
day-to-day basis. I will not go into that detail here as you no doubt have
the knowledge and ability to do that. It works - albeit many times slowly.
2) They would have to come back on different dates to pick up 2 more socks.
We have the same issue with body socks for TLSO's. Here's one even better!
We had Missouri medicaid say that a child could only get 1 forearm crutch
per DOS, so we did 1 one day and they other the next day because I don't why
you would need 2 forearm crutches on the same day! Top that one. It's
getting really stupid!
3) All insurance companies have their BS degree. You will just have to
take it on a case by case basis. Try scheduling this pt. for 2 three weeks.
follow ups to dispense the socks so you have the initial, and two follow up
visits for 3 DOS events.
4) By not accepting assignment. It's the patient's insurance company, let
them handle the problem. Sounds cold, but in today's world, the insurance
companies have named the game; it's called hardball.
Andrea Deshaies-Couture
Business Coordinator
Next Step O & P, Inc.
155 Dow Street #200
Manchester, NH 03101
603.668.3831
603.668.4032 (Fax)
www.nextstepoandp.com < <URL Redacted>>
Notice to Recipient: This e-mail is confidential and meant only for the
intended recipient(s) of the transmission and may be a communication
privileged by law. If you received this e-mail in error, any review, use,
dissemination, distribution or copying of this e-mail is strictly
prohibited. If you are not the intended recipient, please contact the
sender by reply e-mail and please delete this e-mail from your system and
destroy any copies. Thank you for your cooperation.
handle the max units per DOS/year limitations insurance carriers have set up
- Here are the responses:
1) Have not encountered this particular situation, but, there are insurance
that limits the number of socks per year - indicating that they are
disposable items and a predetermined number is what they have arrived at as
reasonable. Our approach is educative -- that is to explain to various
levels of staff at the ins co exactly what an amputee requires on a
day-to-day basis. I will not go into that detail here as you no doubt have
the knowledge and ability to do that. It works - albeit many times slowly.
2) They would have to come back on different dates to pick up 2 more socks.
We have the same issue with body socks for TLSO's. Here's one even better!
We had Missouri medicaid say that a child could only get 1 forearm crutch
per DOS, so we did 1 one day and they other the next day because I don't why
you would need 2 forearm crutches on the same day! Top that one. It's
getting really stupid!
3) All insurance companies have their BS degree. You will just have to
take it on a case by case basis. Try scheduling this pt. for 2 three weeks.
follow ups to dispense the socks so you have the initial, and two follow up
visits for 3 DOS events.
4) By not accepting assignment. It's the patient's insurance company, let
them handle the problem. Sounds cold, but in today's world, the insurance
companies have named the game; it's called hardball.
Andrea Deshaies-Couture
Business Coordinator
Next Step O & P, Inc.
155 Dow Street #200
Manchester, NH 03101
603.668.3831
603.668.4032 (Fax)
www.nextstepoandp.com < <URL Redacted>>
Notice to Recipient: This e-mail is confidential and meant only for the
intended recipient(s) of the transmission and may be a communication
privileged by law. If you received this e-mail in error, any review, use,
dissemination, distribution or copying of this e-mail is strictly
prohibited. If you are not the intended recipient, please contact the
sender by reply e-mail and please delete this e-mail from your system and
destroy any copies. Thank you for your cooperation.
Citation
Andrea Couture, “Max Units Responses,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/228919.
