Civic engagement is the cornerstone of our society. A 20th century politician once said, “there can be no daily democracy without daily citizenship.” However, for those of us in the home care industry, our daily lives are consumed with serving our patients’ needs and meeting the payroll for our employees, and the world in Washington seems far removed from these very important tasks. When you add to that the overwhelming perception of power, influence and money in Washington, D.C., it is easy to become ambivalent about your role in democracy and to question your ability to make a difference. I would like to offer another perspective on the HME provider’s role in democracy. Despite the old adage of “politics as usual,” the political landscape in…

Documentation, reporting, tracking — all items on the salesperson’s “I don’t want to do list.” Just getting a salesperson to complete a weekly call report is a challenge for most managers. They just don’t want to do the paperwork! But the need for completing a comprehensive account assessment is vital to understanding your accounts and tracking the progress of these relationships. As you develop each account assessment, include these 10 basic items: Account assessments must be a work in progress, and these items are only the beginning. You should also include other information, such as tracking the payment sources for the services your client provides. These may be the same financial sources you will need to use for payment for your products. Note any new…

The complicated requirements for Group I and II support surfaces claims involve the “KX” modifier, which must be attached to all such claims. When you attach this modifier, you are stating that all the documentation required by Medicare policy is in the patient’s file. All decubitus care items require a Written Order Prior to Delivery (WOPD), a signed and dated order from the physician prior to delivering the item to a patient. If you fail to obtain a WOPD, the claim will be denied. Even if you obtain the WOPD at a later time, your claim will not be reimbursable under Medicare guidelines. As of April 1, 2003, claims for all items requiring a WOPD were deemed “non-appealable claims.” That means if you attach the…

“Diet.” “Reimbursement.” The mere mention of either word brings up feelings of dread and frustration, mixed with the promise of great rewards. Don’t ask what made me think about dieting as our staff was putting together the magazine’s annual Reimbursement Survey. I’m on a diet at the moment (I’ve tried them all, from grapefruit to South Beach), and who knows what crazy connections go on in a French fry-deprived head? Maybe the belt-tightening most providers are considering these days made me remember that notching in my own belt is a great incentive for sticking to my current calorie-counting regime. (Well, that and the fact that bathing suit season is fast approaching.) Idle musings aside, I can attest that dieting is no fun. Neither is dealing…

Atlanta Soon after Dallas-based Affiliated Computer Systems (ACS) took over HIPAA-compliant electronic processing of Georgia Medicaid claims last year, massive payment processing difficulties ensued — and today the problem still isn’t resolved, according to the Georgia Association of Medical Equipment Services (GAMES). Since last April, Medicaid reimbursements have followed a complicated prospective payment system, said Jason Rogers, GAMES president and vice president of Athens, Ga.-based Care Medical. ACS paid providers a weekly amount based on an average of payments they received during the 12 weeks before April 1, 2003. Earlier this year, the state “stopped paying the prospective payments despite [the fact that current] claim payments were not up [to] previous levels,” Rogers said. He said the state is now withholding half the amount of…

Competition among providers is offering professional referral sources increasing choices, so you should anticipate the concerns of case managers, social workers and continuing care coordinators who are looking for the ideal place to send patients. By helping these sources make appropriate decisions for their clients, you will attract and keep their attention. Ask yourself, for instance, why a social worker should call you. What difference do you make in the lives of particular clients with specific medical problems? Can you qualify your difference from all others in your community? Hospitals, rehab centers and pharmaceutical companies are becoming involved in understanding and tracking outcomes. Now it is our turn to develop outcome information that can be used as a selling and marketing tool, surpassing those mugs…

If obesity were a virus, we would be facing a modern-day plague. As I was driving to work the other day, a commentator on the radio announced that 68 percent of the American public is overweight, which makes me wonder, is being overweight a reflection of the times? Sometimes I get the feeling we are a nation of hedonists, and the only comfort we seek is self-gratification. I love reading that the fast food entrepreneurs are responsible. Are they? They aren’t taking people by the hand and dragging them in for their hamburgers, chicken sandwiches, fries and other inexpensive gastronomical delights. They are merchants, same as you, and they are only filling a niche. As a DME dealer interested in the welfare of your clientele,…