Responses: [OANDP-L] Clerical, administrative and overhead costs for providing single code items
Marty Mandelbaum
Description
Collection
Title:
Responses: [OANDP-L] Clerical, administrative and overhead costs for providing single code items
Creator:
Marty Mandelbaum
Date:
4/13/2012
Text:
Question posted:
Has anyone ever figured out what the average overhead costs are to provide
a patient with a simple one code item such as a cock up splint or cam
walker?
Considering some of the following time commitment of staff and the fact
that we cannot dispense these as over the counter as in chain store
situation:
- Telephone appointment intake
- Forms - preparing, explaining and filing including long term storage
and shredding (HIPPA, patient demographics, photocopying ID, device
receipt)
- Insurance verification, time on phone
- ordering or replenishing stock item, inventory accounting
- billing depositing, reconciliation of accounts
- cleaning patient area, office maintenance
- practitioner fitting, instructions, documentation and f/u
- other thoughts?
Replies:
It's about $100 with the orthosis cost added and no follow-up. Some
companies call these loss leaders and anyone specializing in loss leaders
is soon out of business.
Back in the 90's we figured out that it cost $35 for each pt intake and
paperwork just to establish a new pt.
I would find it very interested and probably higher than most people think.
Please post results.
Rent and associated overhead, malpractice insurance, etc. I am sure there
are several others. You are off to a good start
Yes, I studied this several years ago and did not go into as much detail.
My estimation was, taking in acount proper forms, verifying coverage,
billing etc..., before I saw the patient, when my front door cracks open
and someone has RX in hand, my estimated cost was between 35 and 40
dollars. Keep in mind this was at least ten years ago. With all the HMO
bast#$ds, I don't even want to know what my costs would be today. If I did,
I would probably close of sell.
I've been practicing for 33 years now and am on the way out anyway. Bottom
line, I'm sure the ancillary cost per item is considerably higher.
When I was at Hanger 7 yrs ago (I now have my own place) the price we were
told for paperwork when a patient walks in the door was $27. Without a
practitioner touching them, just to be able to do the billings. It is the
only number I have seen regarding this. Our thought for some of the heel
lift items was to leave a bowl of them on a table and let the pts just take
them if that's what the rx said they needed, but that isn't what we
actually did, (but it would have been less expensive).
I think that is why you cannot schedule a practitioner to see a patient for
a OTS item. They should only patient that need custom fitted or custom
made. I would call this level of work clinical; like orthotics,
prosthetics, fractures, and AFO'S. Items like a cock up splint, stockings,
tennis elbow splint, or arm sling should see a surgical appliance fitter,
equal to a drugstore clerk with a 3 day fitting course. If you do a lot of
shoes and arches you need a ped-orthist not a C.O.. The problem of costs go
up when you don't have enough items in one or the other area to justify a
full time salary for the specialist hired. If a CPO does not have enough
clinical work, and is the owner of that practice he or she may be forced to
accept a lower salary because their discipline is not being utilized full
time. They should then evaluate if they need to close the practice, accept
the situation, or go work for someone else where they can make more $$. $$
does not make everyone happy. A practice may decide to charge a service
code, and define the service fee based on 15 minute slots; similar to a
labor code. This way their time could be justified. If your a medicare
provider I believe you have to implement this charge for ALL your patients.
However I think a much cleaner answer is for the practitioner to see
patients who require only custom fitted or custom made clinical items.
Remove all the stock that is OTS. Arm abduction splints are OTS in our
minds, but require clinical training and must be custom fitted. Most
fracture bracing is OTS in our minds, but require clinical training and
must be custom fitted. A 4 year graduate with the additional training of
post graduate work should not be fitting stockings, tennis elbow straps, or
cock-up braces. I know what I am saying is said every year or two, but hey
what are friends for.
Has anyone ever figured out what the average overhead costs are to provide
a patient with a simple one code item such as a cock up splint or cam
walker?
Considering some of the following time commitment of staff and the fact
that we cannot dispense these as over the counter as in chain store
situation:
- Telephone appointment intake
- Forms - preparing, explaining and filing including long term storage
and shredding (HIPPA, patient demographics, photocopying ID, device
receipt)
- Insurance verification, time on phone
- ordering or replenishing stock item, inventory accounting
- billing depositing, reconciliation of accounts
- cleaning patient area, office maintenance
- practitioner fitting, instructions, documentation and f/u
- other thoughts?
Replies:
It's about $100 with the orthosis cost added and no follow-up. Some
companies call these loss leaders and anyone specializing in loss leaders
is soon out of business.
Back in the 90's we figured out that it cost $35 for each pt intake and
paperwork just to establish a new pt.
I would find it very interested and probably higher than most people think.
Please post results.
Rent and associated overhead, malpractice insurance, etc. I am sure there
are several others. You are off to a good start
Yes, I studied this several years ago and did not go into as much detail.
My estimation was, taking in acount proper forms, verifying coverage,
billing etc..., before I saw the patient, when my front door cracks open
and someone has RX in hand, my estimated cost was between 35 and 40
dollars. Keep in mind this was at least ten years ago. With all the HMO
bast#$ds, I don't even want to know what my costs would be today. If I did,
I would probably close of sell.
I've been practicing for 33 years now and am on the way out anyway. Bottom
line, I'm sure the ancillary cost per item is considerably higher.
When I was at Hanger 7 yrs ago (I now have my own place) the price we were
told for paperwork when a patient walks in the door was $27. Without a
practitioner touching them, just to be able to do the billings. It is the
only number I have seen regarding this. Our thought for some of the heel
lift items was to leave a bowl of them on a table and let the pts just take
them if that's what the rx said they needed, but that isn't what we
actually did, (but it would have been less expensive).
I think that is why you cannot schedule a practitioner to see a patient for
a OTS item. They should only patient that need custom fitted or custom
made. I would call this level of work clinical; like orthotics,
prosthetics, fractures, and AFO'S. Items like a cock up splint, stockings,
tennis elbow splint, or arm sling should see a surgical appliance fitter,
equal to a drugstore clerk with a 3 day fitting course. If you do a lot of
shoes and arches you need a ped-orthist not a C.O.. The problem of costs go
up when you don't have enough items in one or the other area to justify a
full time salary for the specialist hired. If a CPO does not have enough
clinical work, and is the owner of that practice he or she may be forced to
accept a lower salary because their discipline is not being utilized full
time. They should then evaluate if they need to close the practice, accept
the situation, or go work for someone else where they can make more $$. $$
does not make everyone happy. A practice may decide to charge a service
code, and define the service fee based on 15 minute slots; similar to a
labor code. This way their time could be justified. If your a medicare
provider I believe you have to implement this charge for ALL your patients.
However I think a much cleaner answer is for the practitioner to see
patients who require only custom fitted or custom made clinical items.
Remove all the stock that is OTS. Arm abduction splints are OTS in our
minds, but require clinical training and must be custom fitted. Most
fracture bracing is OTS in our minds, but require clinical training and
must be custom fitted. A 4 year graduate with the additional training of
post graduate work should not be fitting stockings, tennis elbow straps, or
cock-up braces. I know what I am saying is said every year or two, but hey
what are friends for.
Citation
Marty Mandelbaum, “Responses: [OANDP-L] Clerical, administrative and overhead costs for providing single code items,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 24, 2024, https://library.drfop.org/items/show/233490.
