Providers report 'service stranded' patients

Tuesday, June 30, 2009

Roger Bowman says six to 10 times a week, a patient visits Penrod Medical Equipment in Salisbury, N.C., to get a wheelchair repaired. The trouble: With the patient’s original provider out of business, he has nowhere to turn for paperwork.

“The patients don’t even know when they got their wheelchair or the last time they had the battery replaced,” said Bowman, a partner at Penrod Medical. “So many people are service stranded, and we want to try to help everybody out, but we’re concerned about getting paid.”

At least four HME companies have closed their doors in his area, Bowman says.

Provider Bob Miller reports a similar story.

“In the last two weeks alone, I’ve had three patients come in looking to have repairs done because their provider has gone out of business or their provider refuses to do repairs,” said Miller, president and CEO of Bach’s Home Health Care Supply in Hackettstown, N.J., in May. “I turned them away. I don’t have time to prove medical necessity for chairs I didn’t provide in the first place.”

When a provider has to pick up where another provider left off, his first step should be calling the interactive voice response (IVR) system for the correct jurisdiction, says billing consultant Peggy Walker.

“Each jurisdiction has a phone number, and it will give you information on the chair, like when it was sold,” said Walker, billing and reimbursement adviser for U.S. Rehab, a division of The VGM Group.

Providers will then want to start a new file, Walker said.

“They’re going to have to get documentation from the patient’s physician and make sure the patient meets the criteria,” she said.

Like Miller, Bowman’s not sure it’s worth all the trouble.

“We may have to start charging these people straight-up cash,” he said.