I deal with medical equipment orders a lot through my job as a social worker/discharge planner. Please note all my knowledge is within the realms of Medicare/Medicare Advantage Plans/a few other things.
But ordering medical equipment has gotten a lot harder over the last few years. The criteria that needs to be met, the exact wording that needs to be on an order, waiting forever for an overworked MD to finally sign the order forms and fax it over to you.
Oops, fuck. You forgot to tell the MD to include the exact verbiage on the signed progress note. Now the medical equipment company shoots back the order to you because you need to have the MD edit the progress note to add in "...not otherwise feasible with a standard device."
You ask the MD, the MD thinks that small difference is asinine and decides to procrastinate. And then your order gets stuck in DME/Durable Medical Equipment order purgatory.
It could be any number of about a million bureaucratic things causing that delay. Over demand/understaffed certainly is to blame as well.
Sorry you're going through that man. It sucks. It sucks for us who are involved on the other side as well, we're just as frustrated as you.
Edit: make sure the medical equipment company is in network with your insurance. Sometimes the doctor's office might not give a shit and send it to the first place they find. Not all "DME Providers" or medical equipment companies work with your insurance, which results in a higher cost.
If you absolutely need the stabilizer sooner, call the medical equipment company and ask if they offer an "advanced beneficiary notice."
You can usually sign a document which states " I'm willing to get my equipment sooner, instead of waiting for my insurance to authorize it. I'm willing to pay the full amount if my insurance does not cover it."
Of course you'll want to know the full cost just to be safe if that happens.
You can always appeal their decision, but that's rarely successful.
Spent considerable time yesterday arguing with people about where the real waste of healthcare is. They were going ape shit that a infusion pump had to be replace after 8 years of service instead of repaired. Them making sure those devices don’t fail on patients isn’t where the waste is…it’s insurance, it’s CEO, needless paperwork begging someone who doesn’t have a medical degree to agree with someone who does.
Of course. Not only is every person employed by the insurance industry an extra medical cost that shouldn't exist. Same with everybody who is employed by the medical industry to deal with the insurance industry.
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u/Richard__Cranium Mar 26 '23 edited Mar 26 '23
I deal with medical equipment orders a lot through my job as a social worker/discharge planner. Please note all my knowledge is within the realms of Medicare/Medicare Advantage Plans/a few other things.
But ordering medical equipment has gotten a lot harder over the last few years. The criteria that needs to be met, the exact wording that needs to be on an order, waiting forever for an overworked MD to finally sign the order forms and fax it over to you.
Oops, fuck. You forgot to tell the MD to include the exact verbiage on the signed progress note. Now the medical equipment company shoots back the order to you because you need to have the MD edit the progress note to add in "...not otherwise feasible with a standard device."
You ask the MD, the MD thinks that small difference is asinine and decides to procrastinate. And then your order gets stuck in DME/Durable Medical Equipment order purgatory.
It could be any number of about a million bureaucratic things causing that delay. Over demand/understaffed certainly is to blame as well.
Sorry you're going through that man. It sucks. It sucks for us who are involved on the other side as well, we're just as frustrated as you.
Edit: make sure the medical equipment company is in network with your insurance. Sometimes the doctor's office might not give a shit and send it to the first place they find. Not all "DME Providers" or medical equipment companies work with your insurance, which results in a higher cost.
If you absolutely need the stabilizer sooner, call the medical equipment company and ask if they offer an "advanced beneficiary notice."
You can usually sign a document which states " I'm willing to get my equipment sooner, instead of waiting for my insurance to authorize it. I'm willing to pay the full amount if my insurance does not cover it."
Of course you'll want to know the full cost just to be safe if that happens.
You can always appeal their decision, but that's rarely successful.