Saturday, November 26, 2022

upsell, down grade ?

Dale Anderson

Hello list:  I recently experienced a situation and was wondering how prevalent it is ?  We had a transtibial arrive in our office wearing a reflex VSP. He did not have enough clearance to equal leg length of sound side by 3cm.  Resulting in back pain, gait issues etc.  After 1 year of wearing this system the patient was in search of competent facility to remedy the problem.  After this intial contact with our office, this patients physical therapist sent patient back to original facility where they equalized leg lengths by replacing reflex VSP with only a foot. According to P.T. this achieved adequate clearance, equalizing leg lengths and alleviating back pain.  
Has anyone else experienced this ? is it done out via poor prosthetic planning.  Do facilities disclose this to the payor and reimburse the difference.  Is the intent to maximize
reimbursement then substitute an inferior product to achieve function and appease patients and referrals sources?  Any others willing to share experiences with situations like this would be appreciated. All responses will be kept confidential unless directed otherwise.

Dale Anderson CPO

West Coast Prosthetics & Orthotics

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