Orthotic Coverage

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This is probably a redundant question, but how are the other podiatrists getting custom orthotics covered. We deal primarily with Medicare patients, but other insurances in the area, such as BCBS, and aetna, only pay a portion of their allowable. Their allowable is never more than $65.00. Our office is losing money on dispensing these devices. Is there something we're missing? Thanks!

 

Hi
We always check the patient's coverage AND deductible prior to casting for orthotics.
If they are not covered or if they have a large deductible that has not been paid, we tell the patient how much the orthotics cost and get 50% at that time and the rest when they pick them up.
If they do not wish to pay out of pocket, so be it. You cannot keep paying for your patients medical care. I have found that payment plans do not work.

As for ways around it. There isn't any honest way around it. Some companies pay for custom orthotics, some do not. You need your billing people to check BEFORE treatment.

Steve

 

Thanks for your response, Steve. I was curious mainly because at the seminars I go to, there are still quite a few orthotic companies, and if they're staying in business, I was wondering if our office was missing something in the way of billing. Thanks again.

Ryan

 

In the UK some of our insurance companies will pay for orthoses, but in the main they will not. they will pay for te treatment and the clinical visit assessment etc but not the orthoses.

and the average cost from the practitioner to the patient across the UK in private practice is around £250.00 (thats around $400 US.) the max that i have heard of is £1500 ($2500) per pair .


of course we do have the fall back of the NHS where all treatments where it is deamed needed are provided free at the point of treatment.

 

Hi Robby
"of course we do have the fall back of the NHS where all treatments where it is deamed needed are provided free at the point of treatment"

May I ask how much the NHS pays?

Steve