SUPERVISION OF ALL REIMBURSEMENT SERVICES
- Charges are pre-authorized, reviewed to meet 3rd party payer medical coverage criteria, properly coded, and submitted daily.
- Financial responsibilities (including co-insurances, allowed deductibles, selfpay, and non-covered items) are thoroughly explained to each patient prior to dispense. Cash/check/credit card payments are deposited into your practice’s operating account daily.
- Insurance claims are tracked throughout the adjudication process and any requests for further information or denials are worked to fruition in a timely manner.
- Receivables are controlled such that 95% of aging is current. Medicare/Medicard reimbursements are EFT deposited in <21 days (far exceeding the Rehab/DME industry average of 73 days).
- Net Collection Rate for orthoses, prosthetics, equipment, and supplies is >98%, well above MGMA standards.
SUPPLY-CHAIN MANAGEMENT
- Manufacture Neutral. DMEPOS are sourced worldwide for the highest quality products. Select OrthoDME is not beholden to any particular manufacturer or distributor.
- Inventory is completely stocked and maintained. The clinic is only billed once a month for the items dispensed.
- Purchasing power is leveraged to positively impact the profitability of the program.
- Latest products to market that meet insurance guidelines and improve patient outcomes are continually introduced to the physicians and staff.
- Detailed utilization and revenue reports are generated to provide real-time feedback to the clinic.
PROVIDER EDUCATION ON COMPLIANCE ISSUES
- Medical policies and procedures are monitored to remain current. Transmittal notices for all payors (including Medicare, Medicaid, Commercial, and Work Comp) are absorbed and studied daily.
- Pricing, data, analysis, and coding (PDAC) rules are strictly adhered and all HCPCS charges go “by-the-letter”.
- All federal and state regulations are enforced including Stark, Anti-kickback, and Arms-length transaction rules.
PERSONNEL MANAGEMENT
- Employee(s) are recruited, hired, trained, supervised, and re-educated to perform all functions of the DMEPOS ancillary program on behalf of the providers.
- Fitter/coordinator(s) assess, measure, fit, educate, and provide follow-up service to all patients receiving in-house orthoses, prosthetics, supplies, and equipment.
- Prehab/Rehab (pre- and post-surgical) protocols are reinforced as part of each patient’s customized continuum of care.
IMPROVE PATIENT OUTCOMES AND MAXIMIZE ANCILLARY REVENUES
- Braces, equipment, and supplies are technically and clinically fitted to deliver dramatic results.
- Patients (and caregivers) are taught donning/doffing procedures, care and instruction, and how the item(s) work to achive the desired results.
- Orthotics and prosthetics fee schedule received a 2.4% increase in 2012. Don’t be held hostage to the looming 27.4% cut in physician payments.
- The provision of durable medical equipment, orthotics, prosthetics, and supplies…and the full reimbursement for such products is the core competency of this highly unique boutique service.