Thank you for your responses – received 19 so far. There were multiple requests to share responses. Since there was a definite consensus, I thought I would summarize.
The overwhelming response was to NEVER, NEVER, NEVER send a mfg. invoice to an insurance company. These invoices are confidential business arrangement between us and our suppliers. (who sometimes offer pricing breaks for $$ level of purchases or discounts for prompt payments)
The responses suggested:
1) When a contract price is not in effect, to get, along with the auth. in advance, a fee confirmation in advance.
2) In California (where we are) the CA Insurance Commissioner’s Office states that O & P facilities are not obliged to provide invoicing, as we are not DME. We do not stand at a counter, receive an order, go to the cupboard, take it out, give it to the person at the counter and say “thank you for shopping at Innovative P & O.” “Come back soon!”
3) Send an invoice from your firm with the L-code and price, which can also delineate what also goes into the delivery of the device, i.e, evaluation, fitting, patient education, follow-up, adjustments, etc.
4) Refer them to the state W/C Fee Schedule for the code THEY approved.
5) Last resort, send copy of the invoice, with price obscured or send packing slip copy which reflects no price.
Thank you,
Debra Adams
Innovative Prosthetics & Orthotics
65 Montgomery Drive
Santa Rosa, CA 95404
707 544-5347
Fax 707 544-5349
