Medicare Compliance & Reimbursement

Don't let manufacturers snow you into investing in new gadgets. You've heard other offices rave about the latest equipment that treats intractable conditions -- but you could be stuck with denials if you make a purchase without doing your homework first. Warning: Manufacturers' sales reps may make vague promises about Medicare reimbursement. For example, they'll promise that Medicare will cover a new technology in most parts of the country. But you walk on dangerous ground if you go solely by the manufacturer's general guidelines. Find out whether your own Medicare carrier covers a new technology, says Jacqui Jones, office manager for Benjamin F. Balme, MD, PC in Klamath Falls, Ore. Check on your private payers, Medicaid, and state workers' compensation insurer as well, she advises. With new technologies, your carrier may wait until the evidence is overwhelming before jumping on the bandwagon. Be proactive: "We always research the codes ourselves first [...]