URGENT IMPORTANT INFO
Mike Rieth, LPO
Description
Collection
Title:
URGENT IMPORTANT INFO
Creator:
Mike Rieth, LPO
Date:
3/28/2013
Text:
It's up to us to know the rules in the profession that we are licensed for. It's up to us to know the LCDs Local Coverage Determinations and guidelines and rules set forth by Medicare. It's up to us to read 5000 + pages of the supplier manuals of which the rules now are changing on a daily basis. I cannot tell you how many hours a day are spent in looking around the net for these updates it's totally out of hand and I'm am with you 100%!
Here's a good one I found out yesterday....NOW LISTEN TO THIS CAREFULLYYYYYYYYY ALL OF US!
In 33 days ..Medicare will be implementing the PHYSICIAN ORDERING AND REFERRAL prescription law.
<URL Redacted>
This is very important!!!!
IF A PHYSICIAN ORDERS A PROSTHETIC OR ORTHOTIC, THEY MUST BE A MEDICARE SUPPLIER AND HAVE A P-TAN NUMBER. HAVING THIS P-TAN NUMBER DOES NOT ENSURE THAT THE PRESCRIBING DOCTOR IS CREDENTIALED WITH MEDICARE TO WRITE PRESCRIPTIONS FOR PROSTHETICS AND ORTHOTICS. UNLESSSSSSSS THIS DOCTOR'S PROVIDER FILE SPECIFICALLY STATES, THEY ARE SIGNED UP IN THE MEDICARE FILE TO WRITE PRESCRIPTIONS FOR PROSTHETICS AND ORTHOTICS. 'ALL CLAIMS WILL BE DENIED IN OTHER WORDS...
if the doctor or his staff..neglected to check the P & O Box on the credentialing application attestation sheet..they are not allowed to write prescriptions for Prosthetics and Orthotics.
I went on to ask..and I have been on the phone now in two days for over 3 hours..being passed all around, and it's like the right hand doesn't know what the left hand is doing..and I stilllllllllll do not have a straight answer on where do we go to find out if the Doctor that wrote the script is actually allowed to write it? Whew!
And now I ask them this question.........IF A PROVIDER HAS AN NPI NUMBER??? DOES THIS MEAN THEY ARE A MEDICARE SUPPLIER. They said NO! THIS TO ME WAS LIKE....ARE YOU KIDDDDDDDDDING ME? So now, if a provider has an NPI number they may or may not be a Medicare provider. And if they are a Medicare Provider, that doesn't mean they are credentialed to write prescriptions for Orhtotics and Prosthetics, and there doesn't seem to be ANYONE, that can tell me if the doctor on the Rx. can actullly write the Rx. for P & O ..they suggest we call the physician's office and ask them. Dahhhh!
I said...you realllllllllllllllly want us to have to call the ordering physician and question him and his credentialing practices, like did y ou check the box for O & P while credentialing? How stupid this sound's..........and I don't feel like questioning our referral sources, they will think we're nutts. I can sure see many more referral's from that office don't ya think? Not!!!!
I't s just so out of hand now , I'm starting to lose sleep..and I honestly don't see any lite at the end any time soon.
I will continue to find a better solution to figure out how we can all ensure ourselves that the ordering/referring doctor is in fact credentialed and signed up w/ Medicare to actually write O & P prescriptions..and be careful everyone, if you fill that script and they are not properly credentialed or that little box on their attestation sheet in their credentialing packett is not chek'd...you just gave away the proshtetic.
I tried again this morning to find a definitive answer to the above. There is nothing in place or no one we can speak to or ask to see if the ordering/referring physician is credentialed to write prosthetic and orthotic Rx's. They said they only thing we can do is call the doctor's office and they should know what services they credentialed for. A simple little check in a box next to O & P on the Medicare Supplier
Application form that is not checked will result in our claims being denied.
I guess we will all have to call the doctor's office and ask them if that box is checked or not. I don't see any other way and I don't feel like losing thousands of dollars, or having to go thru a year of appeals!
Good Luck All.
Nancy
Director of Reimbursement
At my witts ends!
Here's a good one I found out yesterday....NOW LISTEN TO THIS CAREFULLYYYYYYYYY ALL OF US!
In 33 days ..Medicare will be implementing the PHYSICIAN ORDERING AND REFERRAL prescription law.
<URL Redacted>
This is very important!!!!
IF A PHYSICIAN ORDERS A PROSTHETIC OR ORTHOTIC, THEY MUST BE A MEDICARE SUPPLIER AND HAVE A P-TAN NUMBER. HAVING THIS P-TAN NUMBER DOES NOT ENSURE THAT THE PRESCRIBING DOCTOR IS CREDENTIALED WITH MEDICARE TO WRITE PRESCRIPTIONS FOR PROSTHETICS AND ORTHOTICS. UNLESSSSSSSS THIS DOCTOR'S PROVIDER FILE SPECIFICALLY STATES, THEY ARE SIGNED UP IN THE MEDICARE FILE TO WRITE PRESCRIPTIONS FOR PROSTHETICS AND ORTHOTICS. 'ALL CLAIMS WILL BE DENIED IN OTHER WORDS...
if the doctor or his staff..neglected to check the P & O Box on the credentialing application attestation sheet..they are not allowed to write prescriptions for Prosthetics and Orthotics.
I went on to ask..and I have been on the phone now in two days for over 3 hours..being passed all around, and it's like the right hand doesn't know what the left hand is doing..and I stilllllllllll do not have a straight answer on where do we go to find out if the Doctor that wrote the script is actually allowed to write it? Whew!
And now I ask them this question.........IF A PROVIDER HAS AN NPI NUMBER??? DOES THIS MEAN THEY ARE A MEDICARE SUPPLIER. They said NO! THIS TO ME WAS LIKE....ARE YOU KIDDDDDDDDDING ME? So now, if a provider has an NPI number they may or may not be a Medicare provider. And if they are a Medicare Provider, that doesn't mean they are credentialed to write prescriptions for Orhtotics and Prosthetics, and there doesn't seem to be ANYONE, that can tell me if the doctor on the Rx. can actullly write the Rx. for P & O ..they suggest we call the physician's office and ask them. Dahhhh!
I said...you realllllllllllllllly want us to have to call the ordering physician and question him and his credentialing practices, like did y ou check the box for O & P while credentialing? How stupid this sound's..........and I don't feel like questioning our referral sources, they will think we're nutts. I can sure see many more referral's from that office don't ya think? Not!!!!
I't s just so out of hand now , I'm starting to lose sleep..and I honestly don't see any lite at the end any time soon.
I will continue to find a better solution to figure out how we can all ensure ourselves that the ordering/referring doctor is in fact credentialed and signed up w/ Medicare to actually write O & P prescriptions..and be careful everyone, if you fill that script and they are not properly credentialed or that little box on their attestation sheet in their credentialing packett is not chek'd...you just gave away the proshtetic.
I tried again this morning to find a definitive answer to the above. There is nothing in place or no one we can speak to or ask to see if the ordering/referring physician is credentialed to write prosthetic and orthotic Rx's. They said they only thing we can do is call the doctor's office and they should know what services they credentialed for. A simple little check in a box next to O & P on the Medicare Supplier
Application form that is not checked will result in our claims being denied.
I guess we will all have to call the doctor's office and ask them if that box is checked or not. I don't see any other way and I don't feel like losing thousands of dollars, or having to go thru a year of appeals!
Good Luck All.
Nancy
Director of Reimbursement
At my witts ends!
Citation
Mike Rieth, LPO, “URGENT IMPORTANT INFO,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 24, 2024, https://library.drfop.org/items/show/234917.
