Medtrade Attendees Learn How to Work with Non-Medicare Payers

ORLANDO, Fla. (Oct. 10, 2013)—Who are the new DME payers, and how can you get paid by them? According to Mary Ellen Conway, president of the Capital Healthcare Group, Bethesda, Md., there are ways to provide products to Medicare beneficiaries even if you did not win a competitive bidding contract.

Conway shared her wisdom with a packed house at day two of Medtrade in Orlando. One of many strategies shared by Conway included a reminder about the relatively new Independence at Home provision. As a Part B program (targeted at people with chronic conditions), Independence at Home is paid through a contracted agreement between CMS and approved Part B physicians.

“You can go to your physicians and ask, ‘Have you heard about Independence at Home?’” says Conway. “You can ask, ‘Have you thought about making home visits to people who are homebound?’ Physicians can get paid when they are managing all of the post-acute care that must happen. Physicians are going to do their best to keep patients in the home, and they are going to prescribe DME.”

The payments that physicians get to manage chronically ill patients meet the criteria of making home visits and providing care coordination, which includes DME. “The money physicians get paid is to manage the care,” explains Conway, who also serves as a member of the Medtrade Educational Advisory Board. “Physicians can call in home health services. They can call in DME providers to bring equipment. You never have to win a competitive bidding contract to handle these patients. They are straight Medicare, but being managed in a different method.”

Independence at Home was approved two years ago, and once the contracted agreement gets set up by an attorney, Conway says it is a valid way to generate revenue while virtually eliminating the chance of audits. “When you are not billing Medicare, you are not getting Medicare audits,” enthuses Conway. “Physicians are not going to audit your records. If physicians contract an agreed amount with you, they pay you. Physicians get an agreed upon amount to manage that patient. They are not billing it back to Medicare.” Mary Ellen Conway’s entire presentation, along with numerous other informative sessions, will soon be available for purchase via the Medtrade Digital Conference.