Repairs to patient capped rental equipment that were originally billed by the the Scooter Store.
Risky or not?
Repairs at this time are risky without the additional complications of trying to get repairs on rental equipment put out by the previous Scooter Store.
1. The Scooter Store has to send all beneficiaries a letter telling them that they have converted their chairs to a purchase and will not longer bill for them.
2. If a supplier tries to get paid for an item that is a capped rental the claim would automatically deny.
3. So the provider must have a copy of the letter from the Scooter Store for the chair that is being repaired and it must have the actual serial number of the chair to prove it is the same chair they provided.
4. They would have to have proof of continued need and I would suggest getting any original documentation as well because many of these are not documented for in the home use.
Without really good documentation and follow up relating too initial need the provider is at risk for denial and the appeals process at this point is almost at a stand still and will be for months to come. The high chance of denial and the appeals process may not be worth the effort.
I would only recommend to our suppliers that they do these non assigned with an ABN and let the beneficiaries go through the appeals process. The provider can put a note in the narrative stating that a letter from the SS stating this is now purchase in in his files.
The denial will be automatic when the system sees the rental is not complete. If the beneficiary calls 1 800 Medicare and they transfer that base to a purchase it could work but still the provider needs to be aware of all the issues.