Page 18 - HME Business, October 2017

going to be looking for a lot of grassroots support going into next year.” For now, he says providers need to inform lawmakers: “It’s mainly keeping your congressional delegation up to speed on what’s going on, so at the time that we may need to have somebody sign on to a letter, or take the lead on an issue, that they’re ready.”
BILLING NON-ASSIGNED
Jeffrey S. Baird, Esq., chairman of the Health Care Group of Brown & Fortunato, P.C.
From his position, Baird says a key concern for providers is the legal issues stemming from Billing non-assigned, a popular strategy for providers suffering stiff reimbursement cuts.
“When a DME supplier elects to bill non-assigned, it can charge the patient greater than what the Medicare allow- able is,” he says “... And there are no restrictions as to how much more the DME supplier can charge. If the beneficiary
doesn’t like it, he can go elsewhere.
“If it wants to charge less than the Medicare
allowable, it has to be aware of a statute that says that the supplier cannot charge Medicare substantially in excess of the supplier’s usual customary charges unless good cause is shown,” Baird continues. “Now what does that mean? Well it’s not clear what that means. We’ve not had any real clear guidance by the government.”
That uncertainty should sound familiar to any DMEPOS provider. Also it’s important to note that none of this applies to providers
with competitive bidding contracts providing items covered by that contract. In that case the provider take assignment for the bid rate.
Also, providers can’t discriminate against Medicare beneficiaries, meaning that they can’t opt to supply inferior products to Medicare patients and far better options for other patients
Lastly, while billing non-assigned, “the supplier still has the responsibility to collect documents
to justify medical necessity,” he says, because a claim can still be audited. If the claim is recouped, the provider must refund CMS for the reimburse- ment and the patient for the difference.
CREATING EXPERIENCE
Rob Baumhover, director
of retail services for VGM Retail Services
For Baumhover, the priority for retail HME is focusing on customer experience. “If you read any blog right now when
it comes to retail, they’re all talking about store experience,” he says. That starts the moment customers walk in the door. They need to be greeted in 30 seconds. “Sales increase because that customer feels welcome and comfortable.
If no one approaches them, and they don’t see what they’re looking for, they walk right out the door, because they won’t feel comfortable going up and asking that sits behind a desk.”
He also says that providers shouldn’t cram their stores with their entire inventory. Rather, they should showcase items that are frequent sellers, or attract customer interest, and then use signage, displays, and interactive items such as tablets or video displays to showcase other items that aren’t on display. “Less is more,” he explains. “... It’s picking the right product around kind of the right category that you can expand on.”
Such was the case for VGM’s Retail Laboratory at this year’s Heartland event, which used an retail storefront in downtown Waterloo, Iowa to
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