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Old 07-19-2010, 01:50 PM
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Question Repairs.....

I recently read an article regarding ZPIC audits, it basically stated that when servicing patient owned equipment you must re qualify them for whatever item they may have. My question is... Does this only apply to equipment that was not purchased by Medicare or does it apply to ALL equipment. We currently always get a prescription for the parts that are needed along with documentation regarding why the EQUIPMENT itself needs to be repaired but nothing regarding the patient. I have read through the LCD's and Policy Articles and I am unable to find an answer to what is actually required by Medicare for repairs. If anyone has any information regarding this please let me know!! It would be greatly appreciated!!
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Old 07-19-2010, 02:12 PM
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Default Repairs.....

Good question! I also want to know the answer to this. I can't imagine, for
instance, making a patient do a whole new face to face eval with physician
(if we are not original provider and therefore do not have original
documentation) to establish medical necessity for a power wheelchair just to
replace a set of batteries which there is very little profit for to begin
with. If that's the case then no provider will want to service equipment
unless they provided it. And this affects medicare beneficiaries negatively
if their original provider goes out of business or the patient moves. I
imagine medicare bene's would find it almost impossible to get a new
provider to service their equipment under those circumstances.

Best Regards,
Serina Breen
Freedom Mobility Center
586 Parker Ave - Rodeo, CA 94572
Tel 510.799.9920
Fax 510.280.0778
Serina.Breen@comcast.net
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Old 07-22-2010, 01:24 PM
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Hello, well the answer to your question is, medicare will not repair or replace parts on a pmd that was not issued originally from the dme co. I just came back from a seminar spring 2010,noridian admin. Services,the only way they will pay for the services is if we have original documentation on file from the prescribing doctor. Which means, that if beneficiary had the pmd delivered to the door like dme companies have been doing in the valley,los angeles area and it turns out to be fraud,the beneficiary will have a pmd sitting at home with no repairs,unless they pay privately. Not much, we can do there......i mean i tried taking repairs on assignment and auctually tried contacting the dme provider for copies of paperwork,explained to them that the beneficiary did not have means of transportation,and we are closer so we would be able to repair pmd,well they just denied request and did not provide me with documents,even though the beneficiary requested them as well. So, you see it will be time consuming and at the end of the day all the time and effort is not worth it,being that medicare lowers and lowers the allowables every year. Hope this helps.
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Old 07-23-2010, 10:03 AM
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Okay so I spoke with Peggy Walker yesterday ( VGM ) and she told me that even though all the information the auditors are asking for is not required by Medicare that to be on the safe side there are a couple of rules that I can follow.
1. If we did provide the equipment and have the face to face and all the originally documentation then we just need to get follow up notes from the doctors office basically making sure the Pt's condition has not changed. ( preferably within the last 6 months )
2. If another DME provided the equipment, we can still do repairs but it is best to do non assigned claims for these. If you choose not to do unassigned then it would be wise to get a face to face and all medical records as if you were doing the chair for the first time.
Needless to say our office decided to do non assigned claims for these cases.
Hope this helps some it clarified some things for me!
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Old 04-07-2011, 10:48 AM
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Yes, I will agree with the response from Cassie-Peggy is a great advice giver...I would never accept assignment on an item that was provided by another company. I have had to clean up messes from other company's that didn't follow thru and got bit. Just keep the ball in your court!
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Old 04-07-2011, 12:50 PM
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Default Repairs.....

Leader1, you stated, "I would never accept assignment on an item that was
provided by another company. I have had to clean up messes from other
company's that didn't follow thru and got bit."

Can you give me specific examples of how you got burned by repairing
equipment provided by another company? Also, what equipment was involved?

Thanks.

Best Regards,
Serina Breen
Freedom Mobility Center
586 Parker Ave - Rodeo, CA 94572
Tel 510.799.9920
Fax 510.280.0778
serina.breen@comcast.net
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