What is the right thing to do?
AlPikeCP at aol.com
AlPikeCP at aol.com
Sat Jul 28 07:29:14 PDT 2001
In a message dated 7/28/2001 12:54:08 AM Central Daylight Time,
shooter1 at mediaone.net writes:
> Are you implying we wait 90 days after delivery before billing?
Absolutely not, what I am saying is that the amputee has 90 days before it is
final. After 90 days there is no refund in full or in part, and any
adjustments and, etc., are now billed and due. They 90 days also does not
apply to any anatomical changes weight gain, weight loss, medical changes,
and, etc. that the prosthetist cannot control. Some clients have also been
know to over use a new socket before their residual limbs acclimate to the
new environment, one reason I like long term test sockets.
>>>>>What would be ideal is a system of draws like the building trades. You
receive payments throughout the fitting process with a 10% holdback at
delivery for the "punch list" of final adjustments.>>>>
At one time we had a similar system in prosthetics. A 50% down payment was
made when the cast was taken and the balance was paid before delivery of the
prosthesis. The amputee submitted the claim to Medicare or their insurance
carrier and received the funds directly to pay the prosthetist. Then the
amputee started spending these funds on something else before the prosthesis
was finished. We as prosthetists then noticed a guy in OKC getting a lot of
press coverage over his idea of fitting an AK socket and getting paid a lot
more then us for his prostheses. We wanted some of that action and up went
the price of a prosthesis. In Minnesota a new idea came forth called Managed
Care and then history repeated itself back to the times after the Civil War.
>>>>The majority of the fraud I have seen is just that, fraud. People who
take payment and never deliver a product or service, or who bill for
components and services never delivered, or knowingly providing products to
persons not able to use them.>>>>
Or sell them a Mercedes when a Chrysler is all they need. However, most
prostheses are below the $25,000 threshold for legal action.
Al Pike, CP
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