Where the hell have you been? Bionicare was dead 6 years ago when CMS stopped covering it in the East. I won't even go into that mess of a goo-filled garment. That could have been and should have been so much better designed. You HAD to know that RS was gonna chase people..they are desperate for the $. The reality is this: Randy, the then-VP pushed this thing through using a TENS code..then tried to get a drastically higher reimbursement than the code allowed for. A unique HCPCS code means nothing. It's all about the value CMS places on the device. VQ bills it as a TENS because they are getting paid well for their knee brace that serves as the delivery device.
The biggest problem isn't with DME. DME is changing, and RS is too slow to adapt. They hire management from other areas of healthcare who haven't a clue as to how DME works. Your bags are empty. Your products are the same as other sellers (except Nimbus). You compete with the same people who manufacture your equipment. TENS is dead. It's gas money, no more. You need products for Acute and Chronic conditions. You need to cover more than your limited indications. You need to cover more body parts with bracing. Right now your Doctors are giving patients scripts for problems you can't do anything with. Yeah..they are gonna get tired of that. Do you really think they want to have to rememeber if you are in or out of a plan? Can you do a sprained wrist? Is this patient sensitive to co-pays and collection calls? Here is what I know from my experiences there and now solo...I was getting about 1/3 of the true biz at my offices. The rest went out the door because I didn't have the coverage or the product.
Here is what I did today, by 10AM. 1 elderly (but active) lady with foot-drop from Polio and Diabetes. My orders: do whatever I can to help. Payor is Medicare with a good 2nd.
AFO (ankle-foot orthosis) cost $37 Reimburses $233
Add extra ankle strap cost $1 Reimburses $21
Custom Orthotics for AFO cost $105 Reimburses $214
House-call and fitting fees cost $5 gas Reimburses $88
TENS unit for foot pain cost $36 Reimburses $238
TENS Ankle garment cost $76 Reimburses $217
TENS Supplies cost $8/mo Reimburses $38/mo
New Quad Cane cost $14 Reimburses $36
Night Splint for foot/ankle cost $24 Reimburses $117
1 Carpal Tunnel Splint cost $16 Reimburses $112
1 Knee brace for polio leg cost $77 Reimburses $588
So, so the math. Total time spent: 90 mins.
Total cost of equipment: $399
Total reimbursement: $1912
So, a profit of $1500+ on a single patient. After I was done, she could walk unassisted for the first time in 3 years. She could go down stairs without dragging her foot, She had less knee pain and no signs of collapse. The TENS will alleviate pain, and the night splint will eliminate the need to stretch her Achilles every morning for 30 mins.
Had this been an RS patient: you'd have gotten a TENS unit out of it. Someone else would get the rest.
Now, RS does give you a good foundation. They teach you how to really get settled, to get in front of the MD. After that, you gotta deliver, and the game is changing. If you could actually offer the mall the things they really need, you become the go-to guy . This is fact: I get a call a week from some office wanting me to come in on their nickel to tell them what I do. Word gets out. I could work 200 hrs a week if I wanted to. The downside is that I have to pay my own way..and that adds up until the money starts to flow in. A year or so. I went 50K in the hole before I collected enough to pay myself back and then go black.
Tomorrow: 4 LSO's and 1 Cerv-Traction unit. I'll get a TENS on 3 of them, and while chatting I'm sure I'll get a wrist or knee, too. Gotta take advantage of that paid-up deductible before year-end. I'll bill out $2500-$2800 tomorrow, collect $1800-$2000 after costs, and be home for lunch.
So get over Bionicare. You need to be where the payors are with products you can actually get paid for. Don't swim against the tide. One of the reasons RS can't get in-net status with so many companies is because they rammed stuff like the 4i and Bionicare down their throats for years...suing for payment. Well, they remember and now they are in control and RS has their hat in hand begging for a scrap.
