Medicare DME C2C solution issue
Annaldasula CPC, Padmavathi S.
Description
Collection
Title:
Medicare DME C2C solution issue
Creator:
Annaldasula CPC, Padmavathi S.
Date:
1/15/2014
Text:
Hi,
Need any help I can get in this situation.
1. Patient was given an aircast stirrup ankle brace for a lateral malleolus fracture. In the appeal I attached a copy of the xrays showing the fracture clear as day.
2. Attached physicians notes to prior visit and the day the supply was given. I double checked to make sure I was not mistaken. All dates match.
C2c DME Medical Director Janet Lawrence denies our claim saying that the record does not contain clinical notes concurrent with the date of service, which indicate the medical necessity for the ankle control foot orthotic.
When I call the number I never get a return phone call.
What the hell am I missing here. This is for a $70.00 brace denial cannot pursue ALJ because not enough $ in dispute...I mean what are my options here. This is not even a DMe provider it's an orthopedic MD giving it to his own patient. If I wait for another to pursue ALJ I could be past filing deadline on this claim.
How do I complain about this. What am I missing. Is there a way to complaint against C2C solutions itself. What are the medical qualification of Janet Lawrence that she cannot see a fracture on the xray.
Thanks,
Padma Annaldasula CPC
> *CONFIDENTIALITY NOTICE: This electronic communication contains confidential information. It may also be privileged work product or proprietary information and is intended for the exclusive use of the person(s) whose name(s) is(are) indicated above. If the reader of this notice is neither the intended recipient, nor the employee or agent responsible for delivering it to the intended recipient, you are hereby notified that any use, dissemination, distribution, or copying of this information, including any attachments, is strictly prohibited. If you have received this electronic communication in error, please notify the sender immediately via return email or by calling at the phone number shown above and deleting the original email message (including attachments) and any copies or backup copies from your computer system. Thank you.
Need any help I can get in this situation.
1. Patient was given an aircast stirrup ankle brace for a lateral malleolus fracture. In the appeal I attached a copy of the xrays showing the fracture clear as day.
2. Attached physicians notes to prior visit and the day the supply was given. I double checked to make sure I was not mistaken. All dates match.
C2c DME Medical Director Janet Lawrence denies our claim saying that the record does not contain clinical notes concurrent with the date of service, which indicate the medical necessity for the ankle control foot orthotic.
When I call the number I never get a return phone call.
What the hell am I missing here. This is for a $70.00 brace denial cannot pursue ALJ because not enough $ in dispute...I mean what are my options here. This is not even a DMe provider it's an orthopedic MD giving it to his own patient. If I wait for another to pursue ALJ I could be past filing deadline on this claim.
How do I complain about this. What am I missing. Is there a way to complaint against C2C solutions itself. What are the medical qualification of Janet Lawrence that she cannot see a fracture on the xray.
Thanks,
Padma Annaldasula CPC
> *CONFIDENTIALITY NOTICE: This electronic communication contains confidential information. It may also be privileged work product or proprietary information and is intended for the exclusive use of the person(s) whose name(s) is(are) indicated above. If the reader of this notice is neither the intended recipient, nor the employee or agent responsible for delivering it to the intended recipient, you are hereby notified that any use, dissemination, distribution, or copying of this information, including any attachments, is strictly prohibited. If you have received this electronic communication in error, please notify the sender immediately via return email or by calling at the phone number shown above and deleting the original email message (including attachments) and any copies or backup copies from your computer system. Thank you.
Citation
Annaldasula CPC, Padmavathi S., “Medicare DME C2C solution issue,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 24, 2024, https://library.drfop.org/items/show/235963.
