Re/hab provider changes his tune

Thursday, February 28, 2002

PORTLAND, Maine - Five years ago, Jim Greatorex never thought he'd be saying he'd prefer to do business with Medicare to private payers.

"If someone said, 'Medicare,' I used to shudder," said Greatorex, co-owner of Black Bear Medical, which specializes in re/hab, and seating and positioning. "But here in Maine, and in other smaller communities, I think, all the private pays and HMOs are such a mess."

Case in point? Greatorex said he signed a contract with one payer, only to have the payer impose prices 30% lower than what had been agreed to after the payer signed a national contract.

"It's just stuff that you wouldn't do to your worse enemy," he said. "I could go on and on."

Black Bear Medical currently does about 20% of its business with Medicare, Greatorex said.

In the past, Greatorex said he'd file a claim for a high-end wheelchair and "cross every finger and toe" that it wouldn't be denied. But now, especially with prior authorization, dealing with Medicare's not so risky, he said.

"Over the years, we've focused so much on Medicare compliance that our staff knows how to do everything right," Greatorex said. "It's become easier. We know the rules dead on. We know how to play the game now." HME