We often hear from physicians that there are several challenges to implementing Durable Medical Equipment programs into their practices. In this post, we address four common areas of concern and show that when you work with the right supplier, it can be a win-win for both your office and your patients.
First and foremost, quality products are a must. The market is fraught with that products that are poorly designed and constructed. Patients will return cheap products if they’re not satisfied with the results or there are durability issues. Second, find a quality provider with a proven track record. Ask for referrals from their current clients and seek out providers that have commissioned outcome studies to measure the efficacy of their products. In our latest outcome study, Meditech had a product return rate of <1%.It’s important to understand the payers, especially Medicare Local Coverage Determinations (LCD’s), which are decisions on whether a service is considered reasonable by a Medicare Administrative Contractor (MAC). These fiscal intermediaries often determine the national denial rate, which can vary across products and services, but in a recent jurisdictional review of claims for Lumbar-Sacral Orthoses (HCPCS L0631 and L0637) for claims processed from December 2014 through February 2015 there was a claim denial rate of 83% for the 899 claims reviewed. Based on review of the documentation, the following were the primary reasons for claim denials: claims had a missing or incomplete detailed written order, claims had medical record documentation issues, or claims had proof of delivery issues.
In sharp contrast to the national averages, Meditech’s claim denial rate for its full line of products has consistently been in <5%. We asked Meditech CEO Howie Bartz to expand on this important issues and he said, “Every detail of the coverage criteria must be met or providers can expect a denial. We attribute Meditech’s success in this area to closely following Medicare LCDs, submitting proper documentation including medical necessity, and following up with our customers to ensure patient satisfaction. The process to appeal a denied claim can often be a long and arduous process and it’s important that we do all we can to ensure our end-users rarely experience claim denials. We’re extremely pleased that Meditech’s claim denial rate is significantly under the industry average.” It’s also necessary to have someone that specializes in pre-authorizations and have a solid understanding of DME benefits and coverages as different payers have their own specific forms and processes.Patient education is essential to making a DME program successful. At Meditech, our braces were designed by a physical therapist. They are functional in design and worn only during activities that aggravate pain and symptoms. Instructing patients on how and when to use the products to set up the program for success, otherwise the products aren’t utilized in the appropriate manner. It’s important when setting up a DME program to work with a provider that will provide the necessary product eduction and support.As with any business, inventory management it is critical. Having excess products that sit on back shelves ties up cash and doesn’t work well in the long run. A well monitored inventory program requires a provider that will work with your practice and quickly provide products as needed. This system is ideal as practices receive products as they need them and ensures that their patients always have access to the appropriate products customized to their specific condition. Meditech minimizes the inventory that our partners need to carry on site with an inventory ship out model.Meditech has close to a decade of service providing quality medical products packaged with superior clinical support. The business model is unique in that it creates a turn-key program for physician practices that not only benefits the care of patients, but can be a significant source of revenue generation for the practice. Meditech also offers a number of ancillary programs for physicians to its line of products and services, which include: Compound Pharmaceuticals, Genetic (DNA) testing, Urinalysis, Physical Therapy and Medical Billing.
Please contact us today to learn more about best practices in implementing DME program into your practice or clinic.