Prosthetics & MediCare

[OnwardMike at aol.com]

In a message dated 4/8/99 12:15:34 PM Pacific Daylight Time, 
RENARDWC at ctrvax.Vanderbilt.Edu picks up on Geo. B.'s comment and then asks a 
question:

<< GB> The other issue is assignment. I go to a prosthetist and tell him I
     have Medicare and AARP coverage. He tells me, OK, I accept Medicare
     assignment. The work is done and the prosthetist bills Medicare (not
     me) for his usual charge for the service performed.
 
 Assignment? By this you mean, I am assuming, you go to one of your
 choosing? Anyone? Seems that way. Now, have you gone to a prosthetist
 who refuses to touch MediCare? >>

It may not be anyone you might choose but it would be far less restrictive 
than, say, your typical HMO.  If a prosthetist refused to accept Medicare 
assignment, he couldn't have as customers any Medicare patients.  The 
post-65s represent a significant portion of the prosthesis-using population, 
so someone who didn't except assignment -- because he/she felt Medicare's 
allowable fee was too low -- would probably also run afoul of most HMO 
limitations, too, and would have to build a practice on well-to-do amputees 
or the few with very generous insurance policies.

You will recall that this part of the thread started because NovaCare used as 
part of their excuse for selling out to Hanger their problems in collecting 
from Medicare.  It wasn't clear whether the problem was the *amount* Medicare 
would pay or the time Medicare took to pay it.... or both.

Michael B.