[SimplyLori]

I know over the years companies have varied widely on this subject but the bottom line is this:
We get our pumps on no or low cost leases with buy outs based on our volume of pump sets so we haven't always tried too hard to get paid... However with the cost of service and delivery up and the reimbursement for kits and formula down I don't want to let any billing slip through. My problem is trying to form a policy for how and when to restart billing. For example, on a pump that was initially delivered in 05 that wouldn't pay back then due to same/simliar. If I now have another exchange required due to service. I'm thinking I should set it up as if its new with my purchase options letter and start now. If I go back to try to get MS running I will not likely have the purchase option letters because if we weren't going to be able to get paid we certainly weren't giving the patient the option to purchase.... I'm just trying to make sure we collect all the revenue we are due without getting us into any trouble! Any ideas would be helpful... Thanks!

[danielh]

We don't really do many of these anymore, but you need to be careful about billing for the pump. A few years back (maybe 8 or 10) a lot of providers got in trouble for billing pump rentals for pumps they had received at no cost from the manufacturer ( a common practice to encourage the provider to use that manufacturer's pump sets). CMS made the determination that Medicare could not be billed for equipment that had been acquired at no cost. I believe that the pump manufacturers actually had to pay the money back (because the providers had been led to believe it was legit by the manufacturer) but it was one hell of a big mess. So make sure you have "low-cost" not "no-cost" arrangements on the pumps.