Changes Needed

I work for a small, family owned DME company in a rural part of Ohio. One of the many services we offer is home oxygen. We have been accredited for years (long before it was mandatory) and also have state liscensure. The services that we provide to an ever increasing aging and chronically ill population is extremely important. The oxygen payment cap rule and (not-so) competitive bidding is making it harder and harder to offer quality equipment with a high level of service. The constant cuts the government are enforcing, with the goal of lowering cost and increasing quality are doing the exact opposite. The final outcome, if changes are not made, is fewer suppliers, and even higher unemployment rates. Small businesses, such as ours, cannot survive.

Just one specific example of how the oxygen cap is not working is a client we are currently trying to work with. She moved to our area to live with a daughter, due to decling health. She was “stuck” with her current oxygen provider because of the oxygen cap requirement. The current provider is in another state and the family is meeting other family members half way just to get portable oxygen tanks. The supply issue alone is a problem, not to even mention the service component.

It is incredibly important to the future of small businesses (and larger ones too) along with patients that depend on high quality care to remain in their home (thus saving health care dollars)that the oxygen payment cap be removed and (agin, not-so) competitve bidding be dropped.

One Response to “Changes Needed”

  1. ANONYMOUS said:

    Jun 23, 09 at 2:16 pm

    HONESTLY THE ONLY OUTCOME OF COMPETITIVE BIDDING WILL BE THE ELIMENATION OF COMPATITION. ONCE COMPETITORS ARE GONE THE REMAINING FEW WILL HAVE NO INCENTIVE TO PROVIDE QUALITY PRODUCTS AND SERVICES. IN THE LONG RUN WITH FEWER PROVIDORS – PRICES WILL EVENTUALLY WORK THEIR WAY BACK UP – SO THE FINAL PRODUCT WILL BE THE SAME COST, OR HIGHER, WITH LESS QUALITY OF PRODUCTS AND SERVICES DUE TO LACK OF COMPETITION.
    I WOULD LIKE TO ASK THE QUESTION “WHY IS CONGRESS SO EAGER TO START NATIONAL HEALTHCARE WHEN THEY CAN NOT FUND MEDICARE PROPERLY???????” WE NEED TO TAKE A COMMON SENSE APPROACH, A FAIR PRICE FOR A PRODUCT OR SERVICE – LET COMPETITION AND PATIENT CHOICE DECIDE WHO STAYS IN BUSINESS. IMPLEMENT CURRENT LAWS AND GET RID OF SUPPLIERS WITH THE “INTENT” OF FRAUD. WE NEED TO SIMPLIFY THE BILLING PROCESS. EACH REGION SHOULD PROCESS CLAIMS UNDER PART B AND NOT SUBCONTRACT OUT TO 3RD PARTY INSURERS. HAVING SO MANY DIFFERENT CONTRACTORS IS CONFUSING TO BOTH CLIENTS AND SUPPLIERS. WE SPEND ALOT OF TIME TRACTING DOWN CORRECT INSURERS BECAUSE CLIENTS ARE SWITCHING BEWTEEN INSURERS. IT SO BAD THAT OFTEN THE CLIENTS DO NOT KNOW WHO IS THEIR INSURER. WE HAVE CLAIMS NOT GETTING PAID BECAUSE THE 3RD PARTY INSURANCE THAT THEY ARE SUPPOSE TO BE UNDER WILL NOT CLAIM THEM AS THEIR CLIENT. WE TRY TO GET INFORMATION UP FRONT TO MAKE SURE WE ARE BILLING THE CORRECT MEDICARE INSURANCE – BUT LIKE I SAID BEFORE THE PROCESS IS SO CONFUSING AND COMPLICATED THAT EVEN THE CLIENTS ARE NOT SURE WHO IS PRIMARY. WE SHOULD ONLY HAVE TO SUBMIT CLAIMS TO ONE CLEARING HOUSE AND HAVE THAT CLEARING HOUSE SEND CLAIMS TO THE CORRECT CONTRACTOR. WE AS SUPPLIERS SHOULD BE SPENDING TIME TAKING CARE OF CLIENTS AND NOT CORRECTING BILLING CLAIMS. I THINK ACCREDITATION IS A GOOD REQUIREMENT, BECAUSE IT SET STANDARDS FOR EVERYONE.


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