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Orthotics for Medicare patient
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Orthotics for Medicare patient - September 16, 2005 6:26:00 PM
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Justin
Posts: 32
Joined: February 15, 2002
From: SD
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Without going into specifics, I have a Medicare patient who is a prime candidate for custom orthotics, and I'm being told by our intermediary that MC does not cover these (to avoid another discussion altogether, other treatments have tried and failed, and she has some mechanical faults that cannot be corrected by footwear changes or an off the shelf support). Incidentally the person has diabetes, though diet controlled and with no neuropathy / etc. Does anyone have experience with MC in this respect. Thanks in advance..........
Justin
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Re: Orthotics for Medicare patient - September 16, 2005 6:53:00 PM
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drbuddy
Posts: 429
Joined: July 30, 2005
From: Pennsylvania
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Yeah, I ask the patient will you be paying with cash, check, or credit card?
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Re: Orthotics for Medicare patient - September 17, 2005 6:33:00 AM
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FLAOrthoPT
Posts: 1011
Joined: May 8, 2004
From: West Palm Beach
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possibly medicare will cover some aspects since the patient has diabetes...you can make a custom and have the top layer be that diabetic insole and maybe get medicare to reimburse some...other wise, go with off the shelf and adapt with posting you have, which would cost maybe 50 bucks, or throw the guy a bone and charge him what PAL or LANGER or one of those charges you which is about 108 dollars.
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Re: Orthotics for Medicare patient - September 18, 2005 6:08:00 PM
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Justin
Posts: 32
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From: SD
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I cast and use a small lab with the orthotics costing ~$145, which I pass directly on to the patient wihtout markup. My problem is this person is without any real source of funds, and I would like to avoid much, if any, out of pocket expense for them. drbuddy, I like to be sensitive to costs that clients incur, I hope that if I were in their shoes I would get the same treatment.........
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Re: Orthotics for Medicare patient - September 18, 2005 6:19:00 PM
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drbuddy
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From: Pennsylvania
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I understand, but there is only so much we can do. Health insurance is not always interested in what is best for our patients, so we need to understand that and give them what is best for them, regardless of coverage or ability to pay. Sometimes that means offering patients payment plans, allowing them to pay a few bucks a month until paid in full.
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Re: Orthotics for Medicare patient - September 19, 2005 2:07:00 AM
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Sebastian Asselbergs
Posts: 1191
Joined: September 29, 1999
From: Barrie, Canada
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...and for some patients - if you are independent and your own boss - you let the charge slide...or have them bake for you for a few good pies...
_____________________________
Mundi vult decipi
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Re: Orthotics for Medicare patient - September 19, 2005 3:59:00 AM
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truthseeker
Posts: 148
Joined: June 23, 2005
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I agree with Dr. Buddy. If we believe that our services have value (and I do) then we should not feel any remorse about charging a fair price for them. The plumbers don't feel bad about charging $145 for unplugging your sewer.
where is it said that we should write off the charges just because someone wants our product/service but it is expensive? I want a Jag but can't afford one so where is my subsidy???
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Re: Orthotics for Medicare patient - September 19, 2005 5:04:00 AM
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Yogi
Posts: 403
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From: San Antonio, Tx., USA
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Careful with diabetic, the orthosis may need to be pretty accomodative (soft) to be tolerable, also there is alot that can be done with off the shelf stuff from Ali-Med 800-225-2610, just on the off chance that you're not familar with them. Be careful about correcting so much at once that it's not tolerable.
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Re: Orthotics for Medicare patient - September 19, 2005 9:17:00 AM
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Justin
Posts: 32
Joined: February 15, 2002
From: SD
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thanks for the replies, I agree with what everyone is sharing, and yes I certainly believe our services have value and we should be reimbursed acordingly. In regards to off the shelf stuff, I do routinely use these, but for this particular paitent (with an almost comical amount of FF and to a lesser degree RF varus) I just don't think they would work. I'm going to see if her supplement will help (most likely not) or if we can write off the charges (I am in a one man clinic, but owned by a larger regional hospital system).......
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Re: Orthotics for Medicare patient - September 20, 2005 1:55:00 AM
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Sebastian Asselbergs
Posts: 1191
Joined: September 29, 1999
From: Barrie, Canada
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Tom, my suggestion was for a patient who was unable to pay at all. I am not talking about a silly luxury - I am talking about something called community service - does not hurt at times to do something just for heck of doing something good. It also just plain feels good. Doesn't have to cost an arm or leg - especially for a diabetes patient - see yogi's post (so right). And I agree with DrBuddy with possibilities of payment plans - I just like getting home baking. Has never hurt my status as a professional - patient is told "this is between us" - and they will come back or refer others....
_____________________________
Mundi vult decipi
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Re: Orthotics for Medicare patient - September 20, 2005 2:14:00 AM
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truthseeker
Posts: 148
Joined: June 23, 2005
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I have no problem with giving things away once in a while either, it just bothers me that people tend to expect health care to be free. It should be offered by the giver, not demanded by the taker.
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Re: Orthotics for Medicare patient - September 20, 2005 3:49:00 AM
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Randy Dixon
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I've noticed a strange dynamic, private pay patients are usually grateful for the treatments and services they get and many Medicare patients are demanding and unhappy.
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Re: Orthotics for Medicare patient - September 20, 2005 3:52:00 AM
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ehanso
Posts: 355
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From: Minnesota
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There just needs to be a bit more pressure on Medicare to be more realistic. (I know that is a real stretch). But they will cover Viagra and not orthotics or hearing aids. A wonderful system we have.
Justin, does your facility have a free services or other section to write off or discount services to truly needy patients. Some do under their Medicare contracts. I hope things work out for her. I do like Sebastian's pie suggestion though.
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Re: Orthotics for Medicare patient - September 20, 2005 4:29:00 AM
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Yogi
Posts: 403
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From: San Antonio, Tx., USA
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Falls, most ins. covers wellbutrin for depression, but not Zyban for smoking cessation. So then they get to pay for chemo, surg., and rad. Isn't that goofy?
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Re: Orthotics for Medicare patient - September 20, 2005 4:57:00 AM
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ehanso
Posts: 355
Joined: September 14, 2004
From: Minnesota
Status: offline
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Yes, but even with its inconsistencies, the system still is better than some of the socialized ones I have heard about.
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Re: Orthotics for Medicare patient - September 20, 2005 11:57:00 AM
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Sebastian Asselbergs
Posts: 1191
Joined: September 29, 1999
From: Barrie, Canada
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Tom, I agree completely. Yogi, falls - true points - I am in a mix bag of socalled social "universal" healthcare - mixed with private services like mine, chiro, massage, pedorthists, dental etc etc. A jungle for the patient - and some insist that it should be "free". As if it doesn't come out of everyone's taxes....
_____________________________
Mundi vult decipi
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Re: Orthotics for Medicare patient - September 20, 2005 2:50:00 PM
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Justin
Posts: 32
Joined: February 15, 2002
From: SD
Status: offline
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I'm in agreement with all, especially that MC reimbursement is strange in what is and isn't covered. This particular person realy has very little in terms of funds, and certainly isn't demanding that I provide these at a reduced cost or free. I'll likely have the facility bill, not get paid, and eat the cost - if it comes back to me, so be it (I'm sure you'll all agree we develop pretty thick skin after a number of years doing what we do)......
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