[KassDavis]

We have a patient that we provided a power wheelchair for in 2007 the chair was then recouped in 2009 for an error on the delivery ticket. We never picked up the chair because we have always been under the impression that if it was our mistake we could not pick up the equipment. She called last week and her batteries are starting to go dead so we agreed to to do them - unfortunately our batteries have been on order and there is a big mess with that so now she is wanting us to pick up the chair today. Are we able to do this?

Thank you for any input!

[HEATHER]

You could have notified the patient in 2009 that the pwc was ultimately denied and you could have picked it up - unless you advertise that a denied pwc is a free pwc (like some I've seen on tv.) However, I will assume you do not print such a guarantee..

So it sounds like you are saying the patient wants to be rid of it since she cannot get batteries? If this is the case - pick it up if you want - don't if you don't. You may want to see what condition it is in before you decide. But you are not obligated to leave a pwc in the home without reimbursement. You are also not required to provide free batteries. In any case of denial you should give the patient ample time to make other arrangements before you schedule a pick up. Hope this helps.

[Sleeping410]

Items denied with a "co" modifier cannot be picked up, you should only pick up the chair if the denial begins with "pr". (Difference being either contractual obligation or patient responsibility) The reason the commercials run with the "if Medicare doesn't pay, it's free" is because if Medicare denies the chair with a "co" denial the provider can't collect any funds from the patient and cannot pick up the chair.

Sounds like you need to get a billing consultant to review the recoup and see if you can't get paid by correcting the issues with the delivery ticket????

[KassDavis]

Hey! Thank you both for the advice!

[HEATHER]

I'm going to have to disagree with that. If you rented someone a wheelchair and your claim is denied for similar equipment because they got a pwc last year - it will have a CO denial. You are correct that you cannot charge the patient for the rental months that have been billed and denied in this way - but you do not have to leave your equipment in that home for free. Similarly, if you delivered a rolling walker as a purchase item and it was denied for similar equipment (CO modifier) you cannot charge them for the purchase of the walker - your only choices are to pick it up or give it to them for free. If the patient said they wanted to pay privately/unassigned, according to Medicare, you must deliver another piece of equipment and have the patient sign an ABN and a new delivery ticket. But nowhere in Medicare's policy does it say you have to provide equipment for free when it isn't life sustaining equipment. The "if medicare denies it its free" comes from some providers who use it as a marketing device.

[Sleeping410]

Sorry Heather, after I read that, I wasn't very clear. You could get a new delivery ticket, ABN, etc. and bill the patient or you could simply pick up the chair. The point I was trying to make was that the "best" solution would be to get paid. That's a lot of money to just give up on because of some minor glitch in the original delivery ticket.

[HEATHER]

Agreed! (Payment vs. pick up) We've been in this same boat and it is maddening. Sometimes your hands are tied. Medicare's policy even says that in some instances you will not be paid but another "unrelated supplier" can provide the same equipment and it will be eligible for coverage.