[raho]

Just wondering what other offices are doing when they receive the Medicare overpayment requests from the past few years when they determine a beneficiary has had a date of service that fell into the same time period with a skilled nursing facility, home health episode, or enrolled in managed care? When you get the request, you have a month to send the check in, but then what actions are businesses taking with recouping money for supplies that were provided? Any feedback or suggestions would be greatly appreciated. Thank you.

Sincerely,

Robin Aho, Office Manager
Peninsula Pharmacy
raho@penpharm.com 906-225-3902

[Regina]

I immediately send them for offset. Then, you can try to bill for additional months after they were released from the SNF on a rental, if the patient still had or has the equipment.
For home health episodes, I usually bill the home health agency, but I think we have only been paid by them once. It is very frustrating. Where do the home health nurses think the supplies are coming from?
If they were in managed care, often it is too late to get a required auth, so it's money lost.

[Alpha]

We have had this happen with 2 people we supply with catheters. We have actually gotten replacement supplies from the Home Health Agency. This may not be the norm, but it doesn't hurt to ask.

[Regina]

We recently had a rep from a home health agency be VERY rude to us regarding supplies that we had been sending to a patient. He stated that the patient had ordered them, and they had nothing to do with it. When my colleague asked where he thought the supplies they were using on the patient were coming from, he said that wasn't his problem, and told her, "sure try billing us!". Needless to say, we didn't get paid. Aren't we all in this together? geez.

[SimplyLori]

We've lost thousands of dollars on those takebacks and they're still coming now and then no matter how hard we try. I've rolled the bills to the HHA and have gotten a few thousand back but certainly not close to all. Our new policy on Ostomy and Urologicals is to make the patient or caregiver sign a statement at each delivery and if I can't get paid from the HHA we're gonna appeal to Medicare to get a rejection that will allow us to bill the patient.