Here is my original post and I will summarize the responses because there
were not many.
My original post was;
> I know this has been asked before so I am sorry to ask again. We are still
getting insurance companies asking for invoices for custom orthotics and
prosthetics. Has anyone found something in writing that states O and P is
not required to supply an invoice? The insurance companies want us to show
them proof.
I only received 7 responses and all of them stated they were complying with
the insurance companies and submitting an invoice when asked to. It makes me
wonder if this is a localized problem or is it nation wide. I am in Nevada
now, but I was getting these requests when I worked Illinois 5 years ago. I had
a copy of a paragraph that the NovaCare main office sent me and told me to
send it to insurance companies if they asked for an invoice. They said it was
in the new Stark Law. I don’t remember the exact wording but it went
something like this:
Health care providers such as physicians, therapists, pharmacists, etc.,
or anyone who’s primary source of business is not bracing may be required to
supply an invoice for the original cost of the item being supplied and will
be reimbursed 20% over the cost of that item.
Does anyone else remember seeing this? I don’t have a copy it because I left
their employment. It seems like all this started right after the Stark Law
was passed. I have asked the insurance companies to send me copy of something
in writing that gives them the right to ask for an invoice and control my
profit margin but they have refused.
Does anyone know where I can get a copy of the rule, statute, or law that
gives them this right? I don’t have the answer and from the responses I got no
one else does either.
I can’t survive on 20% and no other O and P facility can either. I would
love to hear some ideas on how we can change our future. Change is the only
constant in this world and our profession has the intelligence, the passion, and
the creativity to change things in our favor.
Have a Great Day!
Jim Soltau CP
