- Human Interest
- O&P Practitioner
- Physical Therapist
- Other Healthcare Professional
Posted By: Carey on June 25, 2012
Response below concerning retail.
Carey Jinright, LO, ATP, MSM
Cross & 3
Begin forwarded message:
> From: [E-mail Address Removed]
> Date: June 25, 2012 11:16:06 AM CDT
> To: [E-mail Address Removed]
> Subject: Re: [OANDP-L] Retail
> Hi Carey, Your posted "private Fee schedule " must be higher than what you bill to Medicare or Medicaid. Cash paying customers are included in what is considered you "Private Fee Schedule ". I went through a very long, exhausting and expensive Medicaid audit because my schedule did not reflect this policy. The government can take back up to seven years of payments just for your private schedule being published at a rate lower than what you bill to them., even if you did not take lower payments for those items. Always bill private non-contracted patients higher than the government. Good luck, Ron Cahill CPO
> In a message dated 6/25/2012 11:10:28 A.M. Eastern Daylight Time, [E-mail Address Removed] writes:
> I have not received other responses than four asking for my responses to be posted. Private insurances would fall under contracts that I mentioned. I received my information 6 years ago from Leah Bunch who at the time was a Medicare field agent. That is why I have made it policy over the years, but in todays environment it is no longer feasible. Hence my request for information.
> Carey Jinright, LO, ATP, MSM
> Cross & 3
> On Jun 21, 2012, at 10:13 AM, "Jeff Boonstra" <[E-mail Address Removed]> wrote:
> > I don't think this is right Carey because many private insurance companies
> > pay less than Medicare. Please let me know what you hear back on this, but
> > no I don't think that is correct. You can charge what you want, you just
> > have to be able to justify why you are doing it...cash pay obviously would
> > deserve a discount.
> > I am in that situation right now myself.
> > Jeff Boonstra CP
> > -----Original Message-----
> > From: Orthotics and Prosthetics List [mailto:[E-mail Address Removed]] On
> > Behalf Of Carey
> > Sent: Tuesday, June 19, 2012 8:21 PM
> > To: [E-mail Address Removed]
> > Subject: [OANDP-L] Retail
> > Guys,
> > I would like to know of your strategies. It is my understanding that if you
> > are a Medicare provider you cannot charge anyone less than you charge
> > Medicare. Unless it is a contracted agreement with another entity. Am I
> > understanding this correctly? So, if a patient brings cash in your door, you
> > have to charge the Medicare allowable, right?
> > Carey Jinright, LO, ATP, MSM
> > Cross & 3
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