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competitive bidding. We can expect this to continue to expand during 2018.
But, for providers considering billing non-assigned, there are some key legal considerations, according to Jeffery Baird, Esq., chairman of the Health Care Group of Brown & Fortunato, P.C.
“If a provider 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 says. “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 impor- tant 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.
Moreover, providers can’t discriminate against Medicare bene ciaries, 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 reimbursement and the patient for the difference.
Deeper Retail
Retail sales have been a priority item for providers for years, but it’s time to take things to the next level. It’s not enough to have retail sales, providers need to start thinking, planning and acting like fully edged retail businesses in 2018.
That starts with taking a by-the- numbers approach to their cash sales. If they haven’t already, providers need to start programs to track key perfor-
mance indicators for their retail sales. These include: gross pro t, cash ow, sales per square foot, customers per day, customer conversion rates, average sales
per customer, items per customer, repeat customers, inventory turn times, unit sales, sales by department, sales by sales person, and sales by category.
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Juzo Therapy Tape is part of our complete therapy solutions. This advanced kinesiology tape can be worn up to 7 days and is easy-to-use for your customers. And, because it’s affordable, it helps add cash sales to your bottom line.
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800-222-4999 • support@juzousa.com
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For more information: www.juzousa.com Freedom in Motion
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