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Doesn't this kind of thinking go against the American free enterprise way? Medicare has specific guidelines of who should qualify to get these DME. It is the job of the healthcare professional to evaluate the pt and send the required information to Medicare if he/she believes that the pt may qualify. Medicare should then either refuse or approve of it based on the medical notes.
If the patient feels he or she needs a motorized scooter or wheelchair he/she can pick up the phone and call the doctor's office. This type of direct marketing deceives seniors and encourages fraud. The salespeople will prompt the patients on what to say to the doctor regarding their need for the equipment. I don't see that as free enterprise.
I had no idea! I also work in the Medical Field (Home Health Agencies) and rarely come across DME orders that require more than a cane, a walker or other smaller things...And our main payer is Medicare (along with Medicaid) I have yet to see a Scooter on the DME lists I process on a daily basis. Maybe they are just not that popular in my neck of the woods? lol
The requests we get for motorized scooters and wheelchairs never come through the home health agencies. We get them faxed and mailed directly from the DME suppliers. One of the most amusing requests we received was for a motorized wheelchair for a patient with severe dementia. One of the requirements to receive the equipment is that the patient be able to safely operate the equipment.
Why would you go through DME orders for a cane? That stuff costs like $20 online. If you really want one, it's so much easier just to buy one online. Are people really willing to go through all of that just to save $20?
Maybe if they're living on disability? I know that when I was with my first husband (the blind one), we couldn't have afforded anything, and he did get all of his medical needs for free through Medicaid.
to thepatient? I work in a medical office. We are being inudated with "mobility assessment" forms that the doctors are being asked to complete for the patient to receive a scooter or motorized wheelchair. It seems to me that these companies are soliciting patients. Shouldn't a doctor actually have to write an order for the scooter or motorized wheelchair before sending the Durable Medical Equipment forms to the doctors' office? It would save the government millions of dollars if these companies were not able to market directly to patients.
There have been numerous cases, one in Oakland CA in particular, where fake companies submitted bills for motorized wheelchairs that never existed for patients who never knew they were involved. This is a scam that needs to be REGULATED, but that means Government employees so we can'r do that
The sad part of this, though, is the people who are really in need have to jump through a million hoops because of those engaging in fraud. I have several friends in wheelchairs, both power and manual, and they have to go through tons of BS just to get a chair, or to get maintenance, and even just to prove they still need the chair.
BINGO!
And there is where I get upset about how things are run, also.
I have never known anyone who owned one of those "scooter" chairs. I actually have never seen many of them, except a few at amusement parks and it may be those were rented.
For those folks who are not ambulatory, perhaps this is a solution. But if Medicare is truly paying for that . . . I think it should be only partially covered and available to people who are basically wheelchair bound or have very limited stamina or ability to walk.
The sad part of this, though, is the people who are really in need have to jump through a million hoops because of those engaging in fraud. I have several friends in wheelchairs, both power and manual, and they have to go through tons of BS just to get a chair, or to get maintenance, and even just to prove they still need the chair.
Very true. Five years ago my husband was put through a online Medicare court hearing to get a manual wheelchair that cost less than $2,000 and they required his doctor to fax a two inch thick medical file to them in advance. It was an open and shut case and he got the chair. We were told at the time not to take it personal because Medicare was pulling every 6th claim through the "enhanced" claims process/audit. However, come to find out a couple of years ago the medical supplies dealer we got the chair through had a habit of overselling clients customized chairs when standard ones would do and they got sued by the federal government, then went out of business. That business's clients---not every 6th Medicare chair claims---were getting pulled aside and audited to build their case against them.
I honestly think Medicare is doing a good job of trying to cut fraud and waste but it's going to be an never ending battle because there are so many dishonest and greedy people in the world. That should not be an excuse to dismantle programs that help so many people, though...just find better and better ways to sniff the cheaters out. Part of the Obamacare plan does set up more fraud and abuse catching check points which promises to save billions of dollars.
Quote:
Originally Posted by Boompa
There have been numerous cases, one in Oakland CA in particular, where fake companies submitted bills for motorized wheelchairs that never existed for patients who never knew they were involved. This is a scam that needs to be REGULATED, but that means Government employees so we can'r do that
That's what worries me. They know how to catch the scammers and will do an even better job once they get all their new software programs online with Obamacare, but will that stuff all get cut thanks to the new debt ceiling deal?
to thepatient? I work in a medical office. We are being inudated with "mobility assessment" forms that the doctors are being asked to complete for the patient to receive a scooter or motorized wheelchair. It seems to me that these companies are soliciting patients. Shouldn't a doctor actually have to write an order for the scooter or motorized wheelchair before sending the Durable Medical Equipment forms to the doctors' office? It would save the government millions of dollars if these companies were not able to market directly to patients.
If the patients have the need and the Dr agrees, yes. I don't see how keeping people that have the need unaware that there is something that could help them, does any good. Unless people think sweeping them under the carpet is good. Obviously there are quite a few that do.
If the patients have the need and the Dr agrees, yes. I don't see how keeping people that have the need unaware that there is something that could help them, does any good. Unless people think sweeping them under the carpet is good. Obviously there are quite a few that do.
The physicians for whom I work are certainly intelligent enough to write a prescription for any durable medical equipment the patient might need based on medical necessity. They don't need to be inudated with forms to review for supplies and equipment the patient did not ask them for directly.
The physicians for whom I work are certainly intelligent enough to write a prescription for any durable medical equipment the patient might need based on medical necessity. They don't need to be inudated with forms to review for supplies and equipment the patient did not ask them for directly.
Exactly. If it is a quality of life issue, patients know how to find out what is available out there, too, with or without TV ads, lol.
Docs have too much paperwork already - wh/ is why so many will no longer deal with filing insurance - it is up to the patient.
to thepatient? I work in a medical office. We are being inudated with "mobility assessment" forms that the doctors are being asked to complete for the patient to receive a scooter or motorized wheelchair. It seems to me that these companies are soliciting patients. Shouldn't a doctor actually have to write an order for the scooter or motorized wheelchair before sending the Durable Medical Equipment forms to the doctors' office? It would save the government millions of dollars if these companies were not able to market directly to patients.
I believe you are correct. People know about the scooters, they don't need to see the commercials. I think a lot of people have them just to make their lives easier, they don't necessarily *need* them. If a doc doesn't write an order for it on his own, he probably doesn't believe the person truly needs it. That's just my guess. I'm all for advocating for your own health, don't get me wrong, but that should be a conversation between doctor and patient, not patient and company that just wants Medicare reimbursement.
Let me ask you this: How often does the doctor approve a scooter for the patients when given the assessment form, and do you think the approval rate is accurate based on what you see in the patients?
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