Hello all:
The following are the responses to my theratogs question. Original post then responses. Not much info but some helpful information nonetheless.
Original:
I’m an orthotist in San Antonio. I have a couple therapists interested in
providing, or at least looking into providing Theratogs. They are new to
me, but are very interesting. I’m sure there are applications for them in
our pediatric population, well that is if they perform as indicated in video
demo. Their website is: http://www.theratogs.com/.
They would like help on reimbursement issues and who is best fit to
provide (aka, bill for and get reimbursed) them if indicated.
I noticed on their list of providers was Hanger along with some other O&P
companies. I would like to know if anyone in O&P is using these, are you
getting paid, and if so how. I am not really interested in providing
these, but the question was brought to me.
If any therapists are listening in (lol), I would like to know if you are
getting paid by insurance companies and medicaid, especially Texas Medicaid,
for these. It really seems to me to be a therapy device, and I would prefer therapists
bill for it if they can. There is too much training involved for orthotists, aka office visits.
I will post responses with names unless you request your name be withheld.
Kevin Matthews, CO/LO
Prescott’s O&P
Replies:
For what it is worth…
My name is Bernie Veldman and I am a C.O. at Midwest Orthotic and Technology
Center. We are one of the providers listed on the TheraTog website.
Theratogs are reimbursable, but don’t this is the last thing that you will
want to do for the money.
Certainly they perform as shown in the video. You will be amazed at what
you can accomplish with a TheraTog kit, but Beverly sure makes it look easy.
The included training video is long, but very much worth the time that it
will take you to watch it.
In terms of reimbursement, we use the HCPCS Code E1399. This is a DME code
and it is manually priced. We get paid different amounts from one insurance
company to the next.
This is a great tool to use to build relationships with PTs. I would
suggest that you do what we did. Buy a full kit of the three smallest
sizes. Take them down to your local embroidery shop where you have your
company shirts embroidered and have your logo and the word D E M O put on
them. Then loan them out as to therapists to “try it before you buy it”.
They will work with them with one child or another for a week or so and then
decide if it is a good approach before having you go through the hassles of
dealing with insurance. By the time that you have it approved ordered and
ready, they have done most of the tweaking and you will probably just need
to drop them off at their clinic (maybe during the child’s therapy session)
and do a quick fitting with the PT. It has been a great learning and
marketing tool for us.
Good luck to you, and please feel free to contact me directly if you have
any other questions that I may be of assistance with.
Bernie Veldman, C.O.
Certified Orthotist
Midwest Orthotic and Technology Center
Hi Kevin
I provided a set for a patient of mine. I knew up front that BCBS of MA was not going to pay for it. The family knew up front that BCBS would not pay. I provide them and ended up eating the cost because the family insisted that the health ins. should pay.
Best bet is to let the therapist order and fit them.
John Wall PT, CPO
HI WE DO PROVIDE THERATOG PRODUCTS, HAVE BILLED MEDI-CAL. WE USE LO456,ANDL2O4O IF APPLICABLE. TOM BEALL CPO.
THE OLD MAN FROM THE VALLEY
This is the Beverly Cusik system to cure CP…I have the P.T.s battle this
one….I have been asked to order these for Medicaid pts and have
declined…the PTs do their own AFOs and only call me when they won’t get
paid for something or it’s medicare…Jane Marlor CO FAAOP
