van Halem Group, Ossur build confidence

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Monday, March 30, 2020

ATLANTA – The van Halem Group has been given the “stamp of approval” by Ossur to provide clinical prescreen reviews and appeals services for custom orthotics and prosthetics for the manufacturer’s

customers.

“It’s a testament to Ossur and its allegiance to its customers to reach out to us on their behalf and seek out an arrangement like this to assist them,” said Wayne van Halem, president of the van Halem Group.

The van Halem Group will provide, among other things, a prescreen review of documents to determine if all coverage requirements have been met prior to submission for reimbursement, as well as access to the firm’s team of clinical experts.

Ossur wanted to “introduce” and give a “stamp of approval” to The van Halem Group to help its customers feel more confident providing high-end orthotics and prosthetics, says Linda Collins, director of the OPS Network.

“We know that our customers are clinicians and they’re always looking for ways to be more efficient,” she said. “They don’t always have the time to review their documentation in great detail and compare it to payer policy to make sure they’re providing the evidence for medical necessity. Wayne and his team are experts.”

In addition to time constraints, Ossur’s customers face stingy payers and fairly intense scrutiny, in part because they provide products that cost thousands of dollars.

“We’re seeing payers just saying no and thinking if they say no, you’ll go away,” Collins said. “They don’t think you’ll come back and they don’t think they’ll have to pay the money back.”

Because the majority of Ossur’s customers are independents they can’t afford not to get paid or to go through a lengthy appeals process, van Halem says.

“That’s the benefit, especially, of putting some checks up front in the process,” he said. “They can’t afford to pay $20,000 for a high-end prosthetics and sit there and wait five or six or seven years to get paid.” hme