Discussion4 Comments

  1. Lois Clauss, PMAC

    We are changing our policy on how we handle orthotic coverage with patients. Previously we checked with all insurance companies (except the standards we knew never covered) prior to orthotic casting with patients. It has been a discussion topic that many physician offices do not even check, they automatically tell patients they are non covered and collect for the services. I was interested in knowing if you then submitted all orthotics to insurance companies to see if they were covered and how you handled the ones who actually required a pre authorization number in order to receive coverage (in our state this is required for certain insurance companies). Thank you in advance for your feed back.

    • Hi Lois,

      Our office only checks coverage on a few policy’s that we know cover it. There is only one that requires a prior authorization. Will fill the form out, fax it in. When we receive the authorization we call the patient to schedule the casting appointment. All the other insurances (non-Covered) we offer a letter of medical necessity to the patient and a receipt and let them know it’s patient responsibility.

      We collect the full amount due on day of casting, for all not covered. We collected any deductible and co-payments that would apply for the covered policies. We do have one that its covered however, the rate of pay is really low (79 for a set). So we tell the patient we don’t accept assignment on them.

      I don’t think you should ever tell a patient that its not a covered benefit if it is! You should say we don’t accept assignment on orthotic payments. This will elevate a patient getting upset with you when they really are covered and they can get reimbursed by the insurance company.

      This however it just what we do in our office.

      Cheryl A Bailey, PMAC
      ASPMA Journal Editor

  2. We are having a lot of questions regarding how to properly clean Dremel heads. What is the standard practice for your office? How are you cleaning them? Do you use them in the auto clave or are the heads just for single use? Looking to see what others are doing to see what options we have.

    Thank you,

    Amber PMAC

    • Hi Amber,

      Are you talking about the burr bits? If so, we clean and autoclave them like any other instrument in our office. We only use them once, then wash them, as we don’t use cold sterile of any kind in our office. So we use a wire brush to clean all the instruments. Then we pack them in pouches an autoclave. I hope this helps. So how do you clean/sterile the ones in your office? Let me what other practices do.

      Cheryl Bailey, PMAC, PRAC

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