American Orthotic & Prosthetic Association  
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 Breaking News for O&P Professionals March 18, 2008 • Volume 12 Number 6  
O&P News
Policy Forum Delivers!

Seventy-five leaders from the O&P field met with more than 80 members of Congress and their staff Tuesday, March 11 to deliver the positive message on how the profession and AOPA can help find savings in Medicare by urging more aggressive efforts at curbing fraud and abuse, enforcing licensing laws for access to reimbursement and the benefits of enacting state and federal parity laws. AOPA Board Member Brian Gustin remarked, “The Policy Forum was one of the best I have attended. I had fruitful meetings with all of the people I had appointments with.”

The keynote address by Senator Robert Dole, former Senate Majority Leader and Co-Chair of the President’s Commission on Care for America’s Returning Wounded Warriors, focused on the current and likely future of the O&P profession. Kerry Weems, acting CMS Administrator warmed to the industry’s offer to create a stronger collaboration among the industry, CMS and the Department of Veterans Affairs. Weems also discussed CMS’ support of the Medicare competitive bidding program and surety bonds with attendees.  The agency’s support of these programs will require that AOPA and its members remain diligent in their efforts to ensure O&P’s involvement in these programs remains minimal.  Fred Downs, Chief Consultant for the Prosthetic Sensory Aid Service, Veterans Health Administration, gave a special briefing articulating the VA’s position that veterans deserve the best possible care regardless of cost as the honor-bound duty of the U.S. Government.  He was joined by Donald Dempsey, Associate Director for Human Resource Programs, Office of Management and Budget (OMB), who painted a dire picture for the Medicare Trust Fund, which if not fixed soon, could create catastrophic problems in the future.

Lobbying experts from Congressional offices, major lobbying firms and Congressman Michael Ferguson, (D-NJ) all shared their expertise on how best to tell the story of O&P to educate and convince members of Congress and their staff on how O&P is different from DME and deserves a stronger distinction in future Medicare legislation. Additionally, fundraisers were held for Senator Ron Wyden (D-OR), Rep. David Camp (R-MI) and Rep. Artur Davis (D-AL).
 
Attendees felt energized by the three-day event and many plan to follow up with their Congressional delegations to ensure continued support of these policies.  Look for more information in the May O&P Almanac. For copies of the position papers, visit www.AOPAnet.org.

Questions? Contact Daniel Gurley at dgurley@AOPAnet.org or (571) 431-0812.



 
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Address Change for Medicare ALJ Hearing Requests

The Centers for Medicare and Medicaid Services (CMS) have announced new addresses from providers to use when requesting a hearing before an Administrative Law Judge (ALJ).  ALJ hearings are the third level of appeal for Medicare claims.  Effective immediately, all requests for ALJ hearings must be sent to one of the following addresses, based on the permanent residence of the patient for whom the claim was filed.

If The Patient’s Permanent Residence Is In:
Connecticut, Delaware, District of Columbia, Illinois, Indiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, New Hampshire, New Jersey, New York, Ohio, Pennsylvania, Puerto Rico, Rhode Island, Vermont, Virgin Islands, Virginia, West Virginia, or Wisconsin
 

Office of Medicare Hearings and Appeals
BP Tower & Garage
200 Public Square
Suite 1300
Cleveland, OH 44114-2316
Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, or South Carolina, Tennessee, or Texas

Office of Medicare Hearings and Appeals
100 SE 2nd Street
Suite 1700
Miami, FL 33131-2100

Alaska, American Samoa, Arizona, California, Colorado, Guam, Hawaii, Idaho, Iowa, Kansas, Missouri, Montana, Nebraska, Nevada, North Dakota, Oregon, South Dakota, Trust Territory of the Pacific Islands, Utah, Washington, or Wyoming

Office of Medicare Hearings and Appeals
27 Technology Drive
Suite 100
Irvine, CA 92618-2364



Questions? Contact Joe McTernan at jmcternan@AOPAnet.org or (571) 431-0811.

 
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Yearbook REMINDER

Please review and return your 2008 Data Verification Form to AOPA by March 28, 2008. This form contains the information we will include for your location in the 2008 AOPA Yearbook. Edit this form, including any changes to your company’s information and employee listing, and return it to AOPA no later than March 28 by fax to (571) 431-0899.  If no changes are necessary, please sign and return the form by fax for our records. All listings will be in alphabetical order by last name, unless you indicate otherwise.

Questions? Contact Michael Chapman at mchapman@AOPAnet.org or (571) 431-0843.

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DMEPOS Accreditation Deadline

CMS has announced that all existing DMEPOS suppliers will have to be accredited by September 30, 2009 in order to bill and receive payment from Medicare. After that date, in order to keep your NSC number and your ability to bill for Medicare services, you must meet the Medicare quality standards and be accredited. If you do not, your NSC number will be revoked.
The deadline for new suppliers was March 1, 2008.  If you open a new facility, including satellite facilities after March 1, 2008, they must be accredited before you can receive your NSC number.  CMS considers new satellite offices to be new suppliers.

As a part of the Medicare Modernization Prescription Drug and Improvement Act of 2003 (MMA), all DMEPOS suppliers must meet certain quality standards and become accredited in order to do business with Medicare. This requirement is not connected to the competitive bidding program).  The quality standards can be located on CMS’ Web site. CMS has deemed ten organizations as accrediting bodies for DMEPOS suppliers.  The list of accrediting bodies can be found on CMS’ Web site. 

CMS stressed that suppliers should start the process early, as most accreditation processes take some time to complete. Waiting until the last minute may cause you to lose your NSC number.

Questions?  Contact Daniel Gurley at dgurley@AOPAnet.org or (571) 431-0812.

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March 19 Medicare Audio Conference

Are you tired of endless claim denials and lengthy appeals?  Fed up with expanding DSOs (Days Sales Outstanding)?  AOPA may be able to help. On March 19 at 1:00 pm (EST), AOPA’s reimbursement experts will present a one-hour audio conference entitled, “Tips On Getting Paid.” This audio conference will consist of approximately 45 minutes of verbal presentation followed by 15 minutes of audience questions and answers.  Topics covered during the session include but are not limited to:

- Avoiding simple mistakes
- The importance of modifiers on claims
- Hints on successful appeal strategies
- What to put in the HA0 record on electronic claims
- Protecting your business from denials based on lack of medical necessity

The cost for the “Tips On Getting Paid” audio conference remains $99 per line for AOPA members with no restriction on how many people may listen on a single line. In addition to learning strategies that may improve the financial health of your business, ABC has approved the AOPA “Tips On Getting Paid” audio conference for 1.5 hours of continuing education credit assuming completion of a provided quiz with a grade of at least 80 percent.

Questions? Contact Erin Kennedy at ekennedy@AOPAnet.org or (571) 431-0834.

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AOPAversity in April: Register by March 21 and get $25 off AOPA’s new Coding & Billing Course!

You asked us for a more advanced Coding & Billing Seminar and here it is! Mastering Medicare: Advanced Coding & Billing Techniques, the first course offered by AOPAversity will convene at Bally’s, Las Vegas, April 17-18. This two day course is dramatically revised and features:

- In-depth discussion of denials and appeals
- How to handle medical reviews and audits
- Coding of complex devices, including repairs and adjustments
- In-depth discussion on compliance with Medicare billing rules
- How to meet documentation expectations
- Hot topics of the day
- Break-out sessions for practitioners and office staff

Register before March 21 and save $25 on each registration!

Questions? Contact Erin Kennedy at ekennedy@AOPAnet.org or (571) 431-0834.


 

Office Depot and AOPA: Partnering for Success!

Take advantage of these negotiated deeper discounts, cost saving initiatives, &
procurement solutions to run your business. 60-80%off 75 of the most frequently ordered items; Tech Depot Consultant for IT questions & quotes; custom furniture solutions for Executive Offices - 50-cubicle stations; Copy Print & Promotional Services.
 
START YOUR SAVINGS TODAY-CALL KEITH LILES AT (540) 687-0068.

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More Results from the Member Survey

Again: thank you to the 297 members who completed the AOPA 2008 Member Survey and for creating the Mother Lode of information that resulted.  The 143 page report assembled by AOPA’s consultant, Industry Insights, details information about the Business Profile, Your Existing Business and Practice, Your Future, and Information and Services.

Those completing the questionnaire were overwhelmingly decision makers: Owner/Practitioners (55.9 percent); Owner (17.8 percent); Facility/Business Manager (12.6 percent); Practitioner (7.7 percent); and All Others (6.0 percent). They reported orthotics accounted for 41.7 percent of revenue; prosthetics, 47.6 percent; pedorthics, 6.7 percent; DME, 2.6 percent; and “other,” 1.4 percent.

The AOPA Workgroup charged with analyzing and interpreting the results met March 10 to develop a program for disseminating the results to all members.  The length of the report is overwhelming and how to scale it down into a digestible package is the current challenge.  In the meantime, please watch the Almanac and AOPA In Advance for more details and news on the future distribution of results.

Questions? Contact Steven Rybicki at srybicki@AOPAnet.org or (571) 431-0835.

 

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Having Trouble with NPI?

Do your Medicare claims have an NPI in the required fields? If yes and your claims are rejected for not having an NPI, here are some steps to take. The most important thing to do is click here and check with the NPPES to verify that your data on record is correct. Other concerns that may be affecting these claims: selecting the proper “entity type” on your original NPI application. If you are an individual, select Entity Type 1; if you are an organization, select Entity Type 2.

If all the information is correct and you still have claims rejected contact your local DMEMAC costumer service representative. When you call make sure you have your NPI Registry number, the claim rejection code and message and all pertinent business information related to the problem.

Questions?  Devon Bernard at Dbernard@AOPAnet.org, or (571) 431-0854.

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O&P Resources from AOPA
Save the Date!  AOPA National Assembly September 10-13, 2008

The 2008 AOPA National Assembly will be held at the Hyatt Regency Chicago from September 10-13, 2008.  Online registration will open on May 5 at www.AOPAnet.org.  The premier O&P event of the year, the AOPA National Assembly combines the biggest and best O&P trade show in the country with outstanding business and clinical education (watch future editions of AIA for more info).  It’s also a great chance to network with colleagues, both old friends and new.

Chicago, the site of this year’s National Assembly, really does feature something for everyone.  Whether one is most interested in sports, arts, restaurants, shopping or all of the above, Chicago truly is your kind of town.  For more information on Chicago and the 2008 AOPA National Assembly, click here.

Questions? Contact Tina Moran at tmoran@AOPAnet.org or (571) 431-0808.

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2008 Audio Conference Schedule

AOPA is rolling out this year’s informative series of audio conferences. During these one-hour sessions, AOPA experts will provide up-to-the-minute information on the following topics:

March 19: Tips on Getting Paid
April 23: Hints on Complying with Quality Standards
May 21: Handling Difficult Patients
June 18: Stark/Anti-Kickback Laws
July 16: How to Market your Practice
August 16: VA Issues
September 17: How to Not Get Sued
October 15: Fraud and Abuse
November 19: New Codes for 2008

The value of these audio conference is obvious:

THEY’RE FAST - No wasted time here. Get right to the heart of the matter in a 1-hour block designed to easily fit into your busy schedule.

THEY’RE CONVENIENT - No airlines. No travel. No time out of the office.
Listen from the comfort and convenience of your desk.

THEY’RE EASY - A telephone is all you need. Just dial in, punch in your access code, and you're in. That's it. Follow along with the audio conference handouts provided in advance.

THEY’RE ACTIONABLE - Our audio conferences provide money-saving tactics you can start using right when you hang up the phone.

THEY’RE IDEAL FOR MULTIPLE LISTENERS - Use a speakerphone and as many people as you want can listen in- at no extra cost to you. Many facilities use these sessions as a cost-efficient, time-efficient means of training staff and reinforcing key issues in a fresh new manner that they will remember and act on.

THEY’RE AFFORDABLE - Priced at $99 for members and $199 for non-members, it is a fraction of the cost of travel and attendance fees for other high-priced conferences or seminars.
 
The registration fee for each seminar is still only $99 for members, $199 for non-members. Any number of people may participate from each registered office for one fee.  Each telephone seminar is worth 1.5 Continuing Education Credits; further details on obtaining Continuing Education Credits will be sent via e-mail shortly before each seminar.

In addition, if you sign up for the whole series of 9 audio conferences, you will get two free!

Questions? Contact Erin Kennedy at ekennedy@AOPAnet.org or (571) 431-0834.

 
Need Help? Find It Here.

Reach more prospective employees with the only interactive, O&P-specific online employment network: the O&P Job Board.

AOPA members pay only $80 to post a job. 
Contact Corrinn Mullins at cmullins@AOPAnet.org or (571) 431-0860.

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Membership Matters: Contact Aon’s Affinity Insurance Brokerage Service

AOPA has recently joined forces with Aon’s Affinity Insurance brokerage service to make personal health care mor
e affordable for members. Get your free quote today online at www.affinityhealthinsurance.com or call (888) 470-2121. 


In light of the recent increases in the cost of medical bills and health insurance premiums, AOPA is now helping members meet the challenges of health costs. Aon’s new Affinity partnership with AOPA offers members a wide variety of plans for medical coverage; including plans for individuals and small businesses.

This new health insurance program with Aon’s Affinity provides members access to over 400 top health care providers. Also, dedicated specialists at Aon’s Affinity will help members find the best coverage plan for them based on members’ individual needs. The benefits don’t end there. Aon’s Affinity will also design a personalized benefits package for your office, which can include medical, life, disability, and vision coverage.

Questions? Contact Michael Chapman at mchampan@AOPAnet.org or (571) 431-0843.

 

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AOPA and Chase: If You’re Paying More Than 1.9%, You’re Paying Too Much

AOPA members should check their current credit card processing rate to determine whether it makes sense to switch to the AOPA Chase Paymentech program with processing fees as low as 1.9 percent. Savings can amount to “found” dollars for the bottom line.  As an example, if your current rate is 2.5 percent or more and you process $500,000 annually in credit card payments — the .6 percent savings can mean another $3,000 to the bottom line. That’s like a patient care facility getting a 200 percent return on their annual dues investment in AOPA. Or it’s the same as getting two years of AOPA membership free!

Check your rate and if you’re paying too much, call AOPA’s dedicated payments expert, Eric Mock, at (214) 849-3603. Be sure and mention your AOPA membership.

Questions? Contact Michael Chapman mchapman@AOPAnet.org or (571) 431-0843.
 

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LCodeSearch.com: Quick Response to Coding Questions

LCodeSearch.com is gaining momentum as more and more AOPA members are logging into this Web-based quick reference site to find appropriate coding for hundreds of O&P products. AOPA member manufacturers are adding their products and codes to the site and the AOPA Coding and Reimbursement Committee is verifying accuracy and resolving any coding questions. If you don’t see products of a favorite manufacturer already on the site, remind them that as an AOPA member their products can be added to the site free of charge. All manufacturers will be given an opportunity to enhance their listings, enabling them to communicate extensive product information and post pictures, for a modest annual fee, covering all products posted on the site.

Questions? Contact Devon Bernard at dbernard@AOPAnet.org  or (571) 431-0854.

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Dec. 20 Medicare Audio Conference Now Available on CD


The enormously popular Dec. 20 “New Codes for 2008 and Preparing for 2008: A Competitive Bidding Update” Medicare audio conference is now available for purchase on CD from the AOPA Bookstore.

The cost is $99 for AOPA members and $199 for non-members. Visit the AOPA Bookstore to order.
 
Each informative audio conference is worth 1.5 continuing education credits. Past topics, also available on CD, include: “Why Was My Claim Denied? Hints on Minimizing Claims Denials;” “The New CMS-1500 Form: Get It Right the First Time;” and “Guidelines on Billing Different Venues & Should I participate with Medicare?”

Visit the AOPA Bookstore for a complete list of available topics.

Questions? Contact Erin Kennedy at ekennedy@AOPAnet.org or call (571) 431-0834.

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O&P Insider's Track
The Only Up-to-the Minute O&P Newsli

People In the News

AOPA welcomes George Barnes, our new Program Manager. George previously worked for the University of Maryland as a research analyst and for Johns Hopkins School of Medicine as a research assistant.
 

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Businesses In the News

Thomas W. Lizotte, LCPO has founded Washington Orthotics and Prosthetics, a locally owned O&P company specializing in providing individualized care for people in the Tacoma, Lakewood, and Gig Harbor areas.

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Send Us Your News!

The next AOPA in Advance will arrive in your inbox on April 1. So if you have a new employee or a new office, tell us! Share your news with the over 15,000 readers of the O&P Almanac and AOPA In Advance newsletter. Contact Steven Rybicki at srybicki@AOPAnet.org.

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AMERICAN ORTHOTIC & PROSTHETIC ASSOCIATION (AOPA)

American Orthotic & Prosthetic Association (AOPA)
330 John Carlyle St., Suite 200, Alexandria, VA 22314
Tel: (571) 431-0876, Fax: (571) 431-0899
www.AOPAnet.org