Many questions have been asked about performing repairs for power mobility devices for patients of a company that is no longer in business. Here are some concepts to consider regarding those repairs:
Medicare pays for repairs for patient owned equipment as long as it is still medically necessary.
A. You provided the item and it is now capped out and belongs to the patient.
All you need to do is to repair it. No order required if Medicare paid for the item. You just have to make sure that the patient still needs it in the home.
B. Patient owns the chair and you did not provide it.
The rules are the same BUT—-CAUTION REGARDLESS OF WHAT “ANYONE” SAYS PROTECT YOURSELF!!
1. Check the IVR system to see if and when it was paid for by Medicare, and
2. Get original paperwork if possible for proof of initial medical need, and
3. Get documentation of continued need!, and
4. Get an order for the repairs.
WHY? Because many of the bases that were billed by providers out of business were chairs that were issued but not really needed “in the home”.
1. They may not have met medical need initially due to poor documentation or supplier generated forms.
2. Medicare will tell the patient and you that these are covered.
OK, when an audit happens can you use the statement that Medicare said it was covered?
NO- Why fight these issues in reviews and audits? If the documentation is not there then have
have the patient sign an ABN and do it non-assigned.
Remember—the patient chose this provider and not you. You are not responsible for repairs at all.
Get the information up front and protect your company.
If the items are on capped rental, you cannot repair it unless you want to take over the capped rental and finish it out; which is a losing situation for your company.
Peggy Walker, RN
US Rehab / VGM