Speaker spotlight: Get it right the first time

Tuesday, September 25, 2012

Saying “no” to patients and referral sources isn’t easy, but it’s what power mobility providers need to do more of, says VGM’s Peggy Walker, who will educate providers on proper prior authorization paperwork at Medtrade. Here’s a preview of the advice Walker will share. 

HME News: Are providers prepared for what’s ahead with prior authorization?

Peggy Walker: I guarantee they’re not. They understand what it is, but what they have to realize is just because they get a prior authorization doesn’t mean it will stay covered on a post-pay audit.

HME: What’s an area that’s most often overlooked?

Walker: When the (requirement) says you have to rule out a cane, walker and manual chair, providers aren’t making sure that’s completely ruled out. The physician may write “the patient can’t use these because they have weak upper extremities.” That’s a subjective statement. It needs to be objective.

HME: What kind of challenges should suppliers expect?

Walker: Dealing with patients who say “Well, my friend down the street got one.” They call 1-800-MEDICARE but they don’t know all the rules. It’s difficult to explain to a patient. 

HME: What’s the one thing you most want providers to take away from your session? 

Walker: How to organize your paperwork so that you have a clean claim before you put it in.