If you are in network with Anthem or one of the others tell me what you do in this situation:
Ostomy patient, they need the normal stuff, Anthem reimbursement hardly covers the cost if at all. Even though you are "in-network" what do you do in these situations? Is there anything like Medicare in regards to Upgrade ABN stuff where the patient is going to have to pay something over and beyond or what? How do some of you all handle this situation?
Thanks in advance for you help!
You have to bite the bullet. I would renegotiate your contract ASAP. This is one of the things providers have to consider when they become network with carriers, is to truly review their fee schedule against the reimbursement allowables.
We use an ABN on all ostomy items where we are barely making the cost on the items. Just make sure you have it signed prior to product being delivered each time.
Private Insurance Question
Linear Mode
