The law of averages

Despite a few squawks here and there, Dr. Paul Hughes, the medical director for Jurisdiction A, says that the new billing policy for wheelchair repairs has been getting “pretty good play” among providers. Hughes addressed common questions and concerns about the policy, which went into effect April 1, in a conversation with HME News in late March.

Positive feedback

“We're hearing that the numbers that we picked are right on target. We knew where the numbers were running based on our claims submissions, but we were still a little nervous when we released the policy.”

'Oddball cases'

“There are oddball cases here and there, where it will cost more to repair a wheelchair than we've allowed. We recognize that, yeah, there are probably some providers out there who take eight units of service to swap out a motor, where the average is three. But how many of those people are there compared to how many people there are who do it in one-and-three-quarter units? If you have to eat it once in a while, well, that's just the law of averages.”

Left out

“For repairs not included in the table, we're going to continue doing them the way we've always done them - providers are supposed to provide information on what they did and how long it took, and then we look at that and make a judgment based on our experience on whether what they're charging us makes sense. Basically, it all hinges on the quality and completeness of how providers keep their records.”

Pay off

“The new policy should reward and encourage providers who are efficient and who do a good job.”