Medicare Problems
Wil
Description
Collection
Title:
Medicare Problems
Creator:
Wil
Date:
10/29/2012
Text:
Hello Colleagues and Guests,
As we struggle to find parity with Medicare and their agents, it seems
to me that more effective measures should soon be taken. We have just
received another prosthetic appeal denial wherein medical necessity has
not been adjudicated, due to missing signatures in the physician's
records. These are CMS regulations that physicians typically don't even
know about.
I have been working on a few other projects that may help our cause. One
is a survey that can be found at the oandpsolutions website under
documents, then survey. The purpose for this form is for O&P
practices to distribute the form to their patients/clients for voluntary
completion. The form will then be mailed to an impartial accounting firm
to be held until such time that the survey is closed. The forms would
then be opened publicly in front of a select committee of O&P
professionals. Each practice will have a unique (room) box number on the
mailing address which will identify the practice where the form came
from. Additionally, the envelopes for each survey form completed will be
tagged to the form. While it is recognized that this is not a
scientifically valid survey, it will serve the purpose of getting the
thoughts of our patients/clients regarding O&P care.
Provided the results are favorable to the O&P professionals, the next
step will be to send a letter to the AMA to see if they would be willing
to support our efforts regarding the definitive prescription writing.
The long range plan associated with the survey will be to allow O&P
professionals write the definitive Medicare compliant prescription and
then forward same to the prescribing physician for agreement and final
signature. It has been proposed, and I concur, that a second survey
(short concise version) should be sent to our local physicians to see if
they would support our writing the definitive prescription, doing the
Medicare compliant evaluations, etc. This is something we'll have to
look at. One other part of this project will be to see if we can get the
professional status assigned to O&P professionals. This would then
give us the right to use appropriate CPT codes for evaluations, etc.
Pending your thoughts here, we have an AMA letter standing by and are
hopeful that we can get the appropriate persons to get involved with
that project. If you have any thoughts about who would be best to
represent us with the AMA, we'd like to hear about it.
We look forward to hearing from you.
Wil Haines, CPO
MaxCare Bionics
Avon, IN 46123
As we struggle to find parity with Medicare and their agents, it seems
to me that more effective measures should soon be taken. We have just
received another prosthetic appeal denial wherein medical necessity has
not been adjudicated, due to missing signatures in the physician's
records. These are CMS regulations that physicians typically don't even
know about.
I have been working on a few other projects that may help our cause. One
is a survey that can be found at the oandpsolutions website under
documents, then survey. The purpose for this form is for O&P
practices to distribute the form to their patients/clients for voluntary
completion. The form will then be mailed to an impartial accounting firm
to be held until such time that the survey is closed. The forms would
then be opened publicly in front of a select committee of O&P
professionals. Each practice will have a unique (room) box number on the
mailing address which will identify the practice where the form came
from. Additionally, the envelopes for each survey form completed will be
tagged to the form. While it is recognized that this is not a
scientifically valid survey, it will serve the purpose of getting the
thoughts of our patients/clients regarding O&P care.
Provided the results are favorable to the O&P professionals, the next
step will be to send a letter to the AMA to see if they would be willing
to support our efforts regarding the definitive prescription writing.
The long range plan associated with the survey will be to allow O&P
professionals write the definitive Medicare compliant prescription and
then forward same to the prescribing physician for agreement and final
signature. It has been proposed, and I concur, that a second survey
(short concise version) should be sent to our local physicians to see if
they would support our writing the definitive prescription, doing the
Medicare compliant evaluations, etc. This is something we'll have to
look at. One other part of this project will be to see if we can get the
professional status assigned to O&P professionals. This would then
give us the right to use appropriate CPT codes for evaluations, etc.
Pending your thoughts here, we have an AMA letter standing by and are
hopeful that we can get the appropriate persons to get involved with
that project. If you have any thoughts about who would be best to
represent us with the AMA, we'd like to hear about it.
We look forward to hearing from you.
Wil Haines, CPO
MaxCare Bionics
Avon, IN 46123
Citation
Wil, “Medicare Problems,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/234041.
