We haven't had any Medicare patient's present to the office with the medication. I can say that our Medicare contractor pays promptly when the claim is submitted with the required diagnosis (and medical necessity documented, of course). It is accurate to say that this, typically, is not a money making procedure. We looked at all the different aspects of keeping this "in-house". We are multi-specialty, (family, internal, urgent care, occupation/wc, ortho, neuro, pain mgmt, and infertility) therefore, we can (or try) to send our ortho patient's to our other practices for those particular problems. Also, there are only a couple of ortho practices in our city so there is a competition, per se, for these patients. We, also, keep mind our ancillary services that we can keep in-house, thus increasing revenue. Now, as far reimbursement, the payments are all over the place. Some carriers reimburse very low and some very high. We do keep an eye on these payments and for the most part, we come out even. It was our thought that we would do it one way for all carriers, without exception. In the case of a Medicare patient, if the procedure is being provided for a non-medical necessity, we get an ABN up from if the patient wishes to continue with the treatment. We continue to purchase this product since there were more positives then negatives.
