Recently I've been dealing with an increasing number of patient's who purchase their own DME (Camwalkers, AFOs etc) from online sources that then bring it and ask me to evaluate and show them how to properly use it. I've been considering charging these individuals a $50 DME evaluation fee. My logic is that A) fitting and patient education regarding DME use is not necessarily considered part of the office visit since it has it's own E&M component built into the fee of the device (Insurers are not just reimbursing your the costs of the physical item but also the provider knowledge in properly fitting it to the patient and educating them, B) The evaluation and fitting of the outside DME to the patient often is time consuming, C) and most important, by giving my "blessing" I essentially make myself liable to any issues that could arise with the device. What are you thoughts on the matter?
Patient purchased DME evaluation and fitting fee
- Thread starter king22
- Start date
- Joined
- Feb 2, 2007
- Messages
- 4,142
- Reaction score
- 4,499
I would say to just up your E&M code since it takes more time/complexity to do the visit.
And have your MA do most of the fit instruction on their ebay ankle brace if you are well-staffed.
Creating a cash service is seldom popular. If it works for you, then ok, but these ppl who scour amazon for crutches are obviously the kind who want the lowest price possible. It is just like insurance or massage or taxes or anything... some people want the professional service and personalized eval with accessibility and a real interaction, and some people just want to scout online for lowest rates (massage gun, turbotax, geico, etc). I say let them.
I have no problem with ppl getting their own DME (esp if my office or ortho store device is not covered by their ins or hits deductible), but I do tell them that the higher fee in office/DME store is because the items will usually be high quality and come with professional fitting, sizing, etc - which may or may not be valuable to them personally. DME on aliexpress or FB market or from a relative or whatever is can potentially be wrong size, low quality (dorsal night splint, short CAM boot, flimsy walker, etc), and they mainly won't get the advice on how to secure the brace or boot or walker or gait train, etc properly at the time of acquisition. They will do what they choose, but you can always up the E&M for added time/complexity.
And have your MA do most of the fit instruction on their ebay ankle brace if you are well-staffed.
Creating a cash service is seldom popular. If it works for you, then ok, but these ppl who scour amazon for crutches are obviously the kind who want the lowest price possible. It is just like insurance or massage or taxes or anything... some people want the professional service and personalized eval with accessibility and a real interaction, and some people just want to scout online for lowest rates (massage gun, turbotax, geico, etc). I say let them.
I have no problem with ppl getting their own DME (esp if my office or ortho store device is not covered by their ins or hits deductible), but I do tell them that the higher fee in office/DME store is because the items will usually be high quality and come with professional fitting, sizing, etc - which may or may not be valuable to them personally. DME on aliexpress or FB market or from a relative or whatever is can potentially be wrong size, low quality (dorsal night splint, short CAM boot, flimsy walker, etc), and they mainly won't get the advice on how to secure the brace or boot or walker or gait train, etc properly at the time of acquisition. They will do what they choose, but you can always up the E&M for added time/complexity.
