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Enrollment as a DME Supplier with Medicare (PECOS)

Uncategorized Feb 01, 2021
I get asked regularly about enrollment with Medicare to supply DME, including custom orthoses, to our patients. For today, suffice it to say that the process of enrolling through PECOS is not terrifically intuitive.

A couple of quick answers:
  • Yes, we need to enroll through PECOS to bill Medicare for the L-codes that describe the orthoses we make.
  • And no, we do not need to do that step for most other commercial payers (there may be some exceptions regionally**).
  • And no, mobile practices are not eligible to apply.  Unfortunately.
Here is an enrollment tutorial for initial enrollment for an organization.
Here is an enrollment tutorial for initial enrollment for an individual provider.

In the "checklist" of things needed to apply, there is a step that is potentially confusing... and costly (like $5k costly!). It lists "accreditation" as an orthotic supplier as a requirement.

This document explains the *exemptions* for the accreditation and surety bond steps.... which...
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Staying well during the Coronavirus - my thoughts on health and business

All I can say is “whew”!  I am tired - no doubt so are you. What a strange and unprecedented (in our lifetimes) time we are living through.  We all have felt the fear and uncertainty and interruption and challenge.  Thank you to each of you who have communicated with me in one way or another – practice owners trying to decide what “the right thing” is to do about their businesses or sharing tips to valuable information, and co-workers concerned for both our patients and their own safety, as well as stability.  It all helps.

With that in mind, I want share what we are doing at our hand therapy clinic in Lynnwood, WA (spoiler alert – we are not planning to close unless advised to do so by health authorities) and what I anticipate we will do.  I want to share a little bit about telehealth, particularly for hand therapy.  Finally, I want to focus on the opportunities and the good that can come out of all the uncertainty....

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OTs CAN evaluate without a referral in Washington State

OTs CAN evaluate without a referral in Washington State

And other places!!

Very frequently I hear OTs say, “I met a person who needs OT, BUT.... they don’t have a referral...." And that seems to be the end of the road for the person who needs help! Which is a bummer.

There are two ways a therapist could respond to this scenario.

Option One: “Why don’t you go see your doctor and then come to me for therapy?”

How likely do you think it is that that person in the midst of their busy daily life will actually take the time to do this multi-step process? It's more likely the person will give up and continue suffering than to follow through that maze to get to OT.

There are at least 7 steps in that process: Figure out which doctor, find a phone number or figure out online contact, get an appointment, go to the appointment, pay their deductible or co-pay for that visit, negotiate with the doctor about whether the referral is needed, and FINALLY...

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Can OTs and PTs share patients? (And our toys?)

Uncategorized Jan 22, 2020

Can occupational therapists and physical therapists share patients when working together in the same hand therapy clinic?

The short answer is a qualified “Yes”. It takes some extra diligence and communication on the part of both professionals as well as your support staff, but it can be done. Legally, occupational and physical therapy are separate professions, and the requirements must be met for each profession. As an OT, I have shared patients with PT colleagues in an outpatient facility attached to a physician group as well as a freestanding therapist owned clinic. I have not done so in a hospital facility, and there may be facility considerations or rules in addition to the following things.

And there's always a longer answer..... with more to think about.

Both disciplines are qualified to treat the patient independently, and if you are both caring for the same patient in an overlapping time period, you are essentially treating in parallel... 2 separate evaluations...

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Toolbox: Hand Therapy Clinic

Here's your "startup clinic in a box"! I am often asked about what services I use for various aspects of Hands for Living, my hand therapy clinic in Lynnwood, WA. I am picky, and cost-sensitive, so these things were vetted very carefully... I'll list them here, with some brief thoughts on why they work for us (right now). These things evolve over time as our needs change, but here's what's working as of today. And I noted a couple things I would love suggestions on if you have a great solution! Anything else you want to know about?

If this is helpful to you, will you share it with your practice owner friends or people who are thinking about starting a clinic?


Office Management

Phone & Fax: Comcast Business for Internet and phone and RingCentral SRFax for fax.

Password Manager: LastPass or EnPass. If you don't have one, you need one.

Scheduling: Schedulicity.  I use Acuity now for my clinic and coaching practice, and prefer it over Schedulicity,...

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Treatment tables we LOVE - FINALLY!

Uncategorized Jan 09, 2020

My colleague Laurie and I have been thinking about our workstations. A LOT. For a long time. I can't even tell you how long, but years. The ergonomics can be tough - to help someone (tall or short) with their hand or arm AND to have all the tools, forms, computer, and gear you need within reach.

We finally made these new tables - they raise and lower (quietly and smoothly) with an electric motor to match the height needed for us and our patients. The tops are custom cut (by one of our former patients!), big enough (48.5"x24") to hold the computer and gear, but small enough (6" deep cut out) to be able to reach our people and maintain good eye contact.

The electric base - and the chairs - were purchased on Amazon, and the plastic sheets for the top are 1/2" King Starboard ST and were purchased from Interstate Plastics. Our friend Randy cut the large sheets into the shape/size we wanted and rounded and smoothed the edges. 

We finally made our idea a reality, we love them, and we...

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