Medicare Fraud

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Anonymous said:
That whole line of thinking is total bullshit. if the patient has risk factors that surgery is risky and probably compromised or even a waste of time and money. At $3000 you are almost always likely saving the system money in the long run.
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Then it's the Dr who needs to document these concerns Not a sales rep!
 






Anonymous said:
But that is a fault of the system. If the patient is a smoker, diabetic, or the fracture is hanging around for months ORIF will probably fail. Surgery or revision surgery in a lot of cases is a shitty answer. If the patient heals one month faster the system wins. And why the hell should a patient endure surgery if they can be healed non-invasively. It's just dumb and the taxpayers are not being 'saved'. not by a long shot.
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Show me the Data to prove your theory. I know plenty of diabetics and smokers who heal from casts or surgery if bone is displaced.

Where is the Economic Data?
 






Anonymous said:
What is interesting is I know some people that did go to compliance to blow the whistle on some in leadership concerning writing and faking notes. They had emails to prove it-and absolutely nothing was done. All of those involved are still employed! It just proves the lack of professionalism and carelessness in the company. I am shocked that there hasn't been a major whistleblower suit-there is certainly plenty of shadiness to work with!
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Then your legal department would be liable. Perhaps there was not enough evidence. Best to have DOJ investigate if you can prove wrong doings. Better have evidence. There are investigations going on.
 






Anonymous said:
Relax? As in being a DOS who promotes this tactic? Consult with your legal department. Never ask a DOS.
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Relax, and please realize that our competitors ( and former employees) are posting false information on here to slander the company, and to provide false information to our patients and offices. Sad, but true.
 






Anonymous said:
Relax, and please realize that our competitors ( and former employees) are posting false information on here to slander the company, and to provide false information to our patients and offices. Sad, but true.
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Sad but there is truth to the observations. Also reps who do not disclose a patients out of pocket.
 












Orthofix rep was charged with many crimes and life is ruined, BC he was doing what was accepted as "best practice" to drive sales. BV is putting many at risk. Don't be foolish. Jump ship now
 












Anonymous said:
What about writing your own letters of medical necessity, having the office scan on office letter head? Is that wrong? Seriously asking, my Dos thinks its a best practice.
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Seriously, anybody who does this on any government case is an absolute idiot. If so, you at least better make damn sure it the MDs ink signature and make sure it's scanned in the patient records.

Do not do everything a DOS tells you to do. Don't be stupid.
 






It's obvious that one poster continues to attempt to liken all of us to Orthofix.
Sorry, but their product is clinically inferior and they resorted to doing things unethically to get their rxs. And they were caught, at least some of them. And that is good for our industry.
 






The government does not look at these products differently. Look at your label. You should not promote Exogen for fresh fractures outside of indication. If you do you are putting yourself at risk. Saying things like "dr, if we wait two more weeks, this will be paid for" and meeting a pateint at a 90 day xray is Medicare fraud.
 






Anonymous said:
The government does not look at these products differently. Look at your label. You should not promote Exogen for fresh fractures outside of indication. If you do you are putting yourself at risk. Saying things like "dr, if we wait two more weeks, this will be paid for" and meeting a pateint at a 90 day xray is Medicare fraud.
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Silly comment. Are you claiming that if a Dr. prescribes Exogen at 75 day it is Medicare fraud to wait until 90 days. You believe that Medicare requires that we place the unit outside of guidelines or never place it at all. Why do you think Medicare has guidelines?
 






Do whatever you want. The reality is you cannot coach physicians towards guidelines. Bone healing can progress and x ray interpretation can change in two weeks. If you receive an order and say that if you wait two weeks this will be covered you are committing Medicare fraud. There are thousands of new investigators looking into all DME products, not just bone stims. You are putting yourself in jeopardy if you are doing this.
 






Anonymous said:
The government does not look at these products differently. Look at your label. You should not promote Exogen for fresh fractures outside of indication. If you do you are putting yourself at risk. Saying things like "dr, if we wait two more weeks, this will be paid for" and meeting a pateint at a 90 day xray is Medicare fraud.
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Who are you people? Do you even work in this industry?

If a Medicare order is written outside of guidelines, say at 80 days past the fracture, and the office chooses to bring the patient back in after the 90-day mark for additional X-rays to see if the nonunion persists, that is simply proper protocol, and will ensure that the device is covered properly by the patient's carriers. Otherwise the patient does not receive the device, unless they want to pay for it themselves.
 






Anonymous said:
Who are you people? Do you even work in this industry?

If a Medicare order is written outside of guidelines, say at 80 days past the fracture, and the office chooses to bring the patient back in after the 90-day mark for additional X-rays to see if the nonunion persists, that is simply proper protocol, and will ensure that the device is covered properly by the patient's carriers. Otherwise the patient does not receive the device, unless they want to pay for it themselves.
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Do whatever you want. Ask your dos to give you some guidance in writing regarding this. You won't get anything. Try it.
 












Anonymous said:
Who are you people? Do you even work in this industry?

If a Medicare order is written outside of guidelines, say at 80 days past the fracture, and the office chooses to bring the patient back in after the 90-day mark for additional X-rays to see if the nonunion persists, that is simply proper protocol, and will ensure that the device is covered properly by the patient's carriers. Otherwise the patient does not receive the device, unless they want to pay for it themselves.
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As long as "the dr. " documents fx as a non-union after repeat X-ray then it's above board. But there are reps who give out "loaner units" which means the patient is fitted prior to 90 days and then cues the dr what to write post 90 days Or they draft a note on Drs letterhead on the day they provide the "new unit".

Not just the competitors who do this sort of practice.

Just wait the 90 days, folks. Wait and let the Dr. document. Do not listen to your DOS if they promote this sort of foolishness.
 






Anonymous said:
It's obvious that one poster continues to attempt to liken all of us to Orthofix.
Sorry, but their product is clinically inferior and they resorted to doing things unethically to get their rxs. And they were caught, at least some of them. And that is good for our industry.
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Sorry, but every bone stim company has rouge reps and managers. You are naive or just trying to cover if you think otherwise.
 












Anonymous said:
As long as "the dr. " documents fx as a non-union after repeat X-ray then it's above board. But there are reps who give out "loaner units" which means the patient is fitted prior to 90 days and then cues the dr what to write post 90 days Or they draft a note on Drs letterhead on the day they provide the "new unit".

Not just the competitors who do this sort of practice.

Just wait the 90 days, folks. Wait and let the Dr. document. Do not listen to your DOS if they promote this sort of foolishness.
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Yes, loaner units would be a problem. Either send them to patient advocacy or wait 90 days.
 






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