Incarceration, etc.
Wil Haines
Description
Collection
Title:
Incarceration, etc.
Creator:
Wil Haines
Date:
7/31/2013
Text:
Dear Colleagues and Guests,
Two things. First, the statement by CMS for us to stop going to the
Social Security office to get incarceration matters straightened out is
a little short-sighted in my opinion. If appeals are not filed within
the allotted time limits, then you lose the right to appeal and, hence,
the case. Not going to SS does not make sense, so we are moving forward
accordingly. I would give this some consideration. Second, the Dear
Physician letter from August 2011 is also a problem in my opinion. The
first paragraph of their letter states /in the event of an audit, the
Medicare (audit) contractor........... etc. /The problem with this
statement is that if a physician leaves their practice, retires, etc.,
and the information from that physician is no longer available, then the
O&P practice will take the direct hit when an audit occurs and the
information is no longer readily available. So the letter should read
that the physician clinical information is required in the O&P record
when services are rendered, not just after an audit. Additionally,
paragraph two states that it is critical that the physician document the
functional capabilities, both before and after amputation. Why would a
(family practice) physician document functional capabilities
(K-Level-wise) before an amputation? And, in the case of an emergency
amputation, which happens more often than we care to know, how would the
surgeon be able to document pre-amputation functional capabilities with
certainty?
As such, I believe their letter needs to be re-written by CMS and sent,
once again, to the physicians to give clarification to the two
aforementioned issues. Anyone disagree?
As we put information together so that all of our records are in
compliance with CMS, some of these issues are starting to surface. If
other issues have been identified, it would nice to hear about them. Thanks.
Wil Haines, CPO
MaxCare Bionics
Avon, IN
Two things. First, the statement by CMS for us to stop going to the
Social Security office to get incarceration matters straightened out is
a little short-sighted in my opinion. If appeals are not filed within
the allotted time limits, then you lose the right to appeal and, hence,
the case. Not going to SS does not make sense, so we are moving forward
accordingly. I would give this some consideration. Second, the Dear
Physician letter from August 2011 is also a problem in my opinion. The
first paragraph of their letter states /in the event of an audit, the
Medicare (audit) contractor........... etc. /The problem with this
statement is that if a physician leaves their practice, retires, etc.,
and the information from that physician is no longer available, then the
O&P practice will take the direct hit when an audit occurs and the
information is no longer readily available. So the letter should read
that the physician clinical information is required in the O&P record
when services are rendered, not just after an audit. Additionally,
paragraph two states that it is critical that the physician document the
functional capabilities, both before and after amputation. Why would a
(family practice) physician document functional capabilities
(K-Level-wise) before an amputation? And, in the case of an emergency
amputation, which happens more often than we care to know, how would the
surgeon be able to document pre-amputation functional capabilities with
certainty?
As such, I believe their letter needs to be re-written by CMS and sent,
once again, to the physicians to give clarification to the two
aforementioned issues. Anyone disagree?
As we put information together so that all of our records are in
compliance with CMS, some of these issues are starting to surface. If
other issues have been identified, it would nice to hear about them. Thanks.
Wil Haines, CPO
MaxCare Bionics
Avon, IN
Citation
Wil Haines, “Incarceration, etc.,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/235375.
