Nekos-Dedricks Pharmacy

While Kingston, N.Y.- based Nekos-Dedricks Pharmacy does a fair amount of Medicare business, it takes an approach that not many HME providers are willing to follow: It charges upfront for items and lets the beneficiary file for reimbursement.

Most HME providers are reluctant to use such an approach because they fear alienating their customers. But owner George Nekos thought it was worth the risk.

“If we had continued to accept assignment across the board, we wouldn't be here anymore,” he said. “It has happened to others in our area.”

Low reimbursement for diabetes, ostomy and urology supplies, in particular, have made accepting Medicare assignment nearly impossible, Nekos said.

“Medicare reimbursement levels stay the same while our expenses keep going up,” he said. “Our philosophy has traditionally been to try and accept assignment where we can, but the situation has continued to get worse.”

Customers, overall, have been cooperative and understanding, he said.

“People are willing to pay for expertise and customer service,” Nekos said. “They have the option of using a mail-order company, but they prefer to deal with us. We have three licensed practical nurses  on staff. We show them how to use a glucometer, and they know if they have a problem they are taken care of.”

To help ease any financial burdens this approach may cause to customers, Nekos-Dedricks allows purchases to be placed on a “tab” so that the bill doesn't come due until reimbursement is received.

Retail sales of compression hosiery and bath safety products have augmented the company's revenue stream, and it still accepts Medicare assignment for items with an acceptable reimbursement rate.

“I'm not saying to disconnect with Medicare completely,” Nekos said. “You just need to know which things are worth your while and which ones aren't.”