Dear Colleagues,
I would like to know if anyone has fitted bilateral BK prostheses to a Medicare patient that has a motorized wheelchair that was paid for by Medicare? Will Medicare pay for the prostheses?
I would appreciate your responses.
Merry Christmas and a Happy New Year !!
Stephen Rinko, CPO#627
—–Original Message—–
From: Orthotics and Prosthetics List [mailto:[email protected]] On Behalf Of Herb Shalant
Sent: Tuesday, December 15, 2015 5:58 PM
To: [email protected]
Subject: [OANDP-L] FW: Again with One Limb Per Lifetime in NY
Colleagues,
Again with the Affordable Care Act limitation in NY and Blue Cross!!!
I thought we won this battle.
But today I am being told after multiple re-examinations of a claim to Blue Cross that because they paid partially for stump socks for a below-knee amputee, and they consider that payment as part of their prosthetic benefit, she has maxed out her lifetime prosthetic coverage under the One Limb per Lifetime limitation.
In other words, because she received socks she can’t get a prosthesis ever under their plan!!!
AM I ALONE???
Is any other facility having similar denials?
I’d like to present this to our State and Congressional representatives, but this will only be anecdotal if I can’t get your help to show this as a systemic problem.
Please share this with your billing personnel and let me know if I am not alone.
Together we can make a difference.
Herb Shalant, C.P.O.
White Plains, NY
—
This email has been checked for viruses by Avast antivirus software.
https://www.avast.com/antivirus
******************** To unsubscribe, send a message to: [email protected] with the words UNSUB OANDP-L in the body of the message.
If you have a problem unsubscribing,or have other questions, send e-mail to the moderator Paul E. Prusakowski,CPO at [email protected]
OANDP-L is a forum for the discussion of topics related to Orthotics and Prosthetics.
Public commercial postings are forbidden. Responses to inquiries should not be sent to the entire oandp-l list. Professional credentials or affiliations should be used in all communications.
