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Got FAQs?
By Lisa Lake-Salmon  The future of your practice depends on
knowledgeable billing and collection information. Understanding the
full aspect of billing guidelines and procedures will effectively
increase your reimbursement. This informative column will help
providers and their staff with a better understanding of billing
procedures and reimbursement strategies.
Q: If there is a Medicare allowable, can a provider
charge for an item when the manufacturer does not charge for it
separately?
A: The provider cannot bill Medicare when the
manufacturer's invoice does not reflect a separate charge for the
item in question.
Q: A patient came into my office with a prescription for
a CAM walker. The patient had already received an AFO brace in the
beginning of the year. Will Medicare now pay for the CAM walker,
and if so how should I bill? Please help, as I can not afford to
keep giving products away free.
A: Medicare will not cover a CAM walker, since
the patient already received an AFO brace in the same calendar
year. If you give the patient a CAM walker, you must have the
patient sign an ABN form (Advance Beneficiary Notice), informing
the patient that Medicare will not cover this item and the cost
would be his or her responsibility. You need to bill using the GA
modifier, letting Medicare know that you have a signed ABN on file.
This then will allow you to bill the patient once Medicare
denies.
Q: I received an overpayment request that I disagree
with. If I appeal the request, do I still have to refund the money
to Medicare?
A: Yes. A request for an appeal will not alter
the overpayment request. If an appeal results in a partially or
fully favorable decision, an appropriate refund will be made to the
provider. Any overpayment due to Medicare should be made within 30
days after the first demand letter.
We invite readers to ask questions you have regarding
billing, collections, or any other information. To send your
questions or for more information, contact: lisa@weternmediallc.com
Acc-Q-Data provides billing, collections, and practice
management software serving the O&P industry nationwide for
over a decade. Lisa Lake-Salmon is Executive Vice President, Acc-Q-Data Inc. 
Table Of Contents - December 2005
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O&P Community Rallies Support for Katrina Victims
In the wake of Hurricane Katrina, many in the O&P field have offered financial assistance, support, and relief to the victims of what has been called the greatest natural disaster the US has ever faced.
Feature
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Prosthetist/Orthotist Rescues Animals from Katrina Disaster
A well-known member of the O&P community, Ronnie Graves, CO, BOCPO, LPO, RTP, heroically assisted in the rescue of hundreds of animals in Mississippi.
Feature
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Pedorthics: Helping People Get Back to Work
Not every pedorthist faces a first-time workers-compensation case like this one!
Stepping Out
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Natural Disasters: Can Your Practice Survive?
Legal EDGE
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Karl Fillauer: Passionate about O&P
Industry Leader
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Hans Richard Lehneis, PhD, CPO, Passes
Industry Insight
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Got FAQs?
Got FAQs?
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Luci Busch, RTP
Profile
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Please Don’t Shoot the Messenger
Perspective
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From the Editor: New Managing Editor Joins The EDGE
Viewpoint
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