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AIAAOPA in Advance

Breaking News for O&P Professionals
February 19, 2008 ♦ Volume 12 Number 4
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O&P News
2008 AOPA Policy Forum: MAJOR UPDATES

We are very excited about this year’s Policy Forum in Washington, D.C., March 9-11. At this point we are proud to announce some scheduling developments. Highlights of the Policy Forum now include:

- Former Senator Robert Dole will speak to attendees about his recent role as Co-Chairman of the President’s Commission on Care for America’s Returning Wounded Warriors.

- We have secured a rare commitment from White House Senior Health Policy staff to conduct a specialized briefing-about only O&P, and directed only to Policy Forum attendees. When have we, or will we have again, the chance for a face-to-face conversation with White House staff leadership that sets health policy for the entire nation, including Medicare, Medicaid, VA, and active duty military?


- CMS Administrator Kerry Weems will address our AOPA membership. This is a great opportunity for us to have one-on-one interaction with the chief of Medicare!
We have some heavy hitters joining us at this year’s Policy Forum. With changes to Medicare looming on the horizon, we must represent to Congress the concerns and issues we have for our profession.

Now we just need to show them our industry speaks with an organized voice!  We hope we can count on your attendance to ensure we achieve our goals this year with Congress. O&P needs you to stand up and speak for the profession!

The Hyatt Regency Bethesda room block has closed as of Feb. 15, 2008. Rooms may still be available on a "space available" basis if you call ZACH BEADLE, directly, at (301) 657-6445. The group rate will be guaranteed for our group if any rooms remain available.

To register for the Policy Forum and to view a draft agenda click here or contact Erin Kennedy at (571) 431-0876.

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

CMS Awards Contract for Front-End Processing of Electronic Claims

The Centers for Medicare and Medicaid Services has awarded the contract for the Durable Medical Equipment (DME) Common Electronic Data Interchange (CEDI) process to National Government Services, Inc.  NGS also currently holds the contract for the Jurisdiction B DME MAC.

Currently, each of the four DME MACs handles EDI enrollment and electronic claim acceptance independently.  Once an electronic claim is run through basic “front end” edits such as verification of patient eligibility, correct completion of required fields, and verification of provider enrollment, the claim is declared “clean” and continues through the claim adjudication process.

According to CMS, the creation of a single contractor to handle the front end edit process on electronic claims will ensure consistent acceptance of clean claims regardless of which DME MAC adjudicates the claim.  The system is being phased in over time with the following key dates:

March 31, 2008—Jurisdiction A and D will no longer process requests for new submitter IDs or changes to existing submitter IDs for electronic billing purposes.

April 30, 2008—Jurisdiction B and C will no longer process requests for new submitter IDs or changes to existing submitter IDs for electronic billing purposes.

May 1, 2008—All Jurisdiction A and D EDI transactions will be processed by the new CEDI.

June 1, 2008—All Jurisdiction B and C EDI transactions will be processed by the new CEDI.

You should receive specific instructions from your DME MAC regarding any system changes that will need to be made to your claim submission software to accommodate these upcoming changes.

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

 

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Big Win for Survey Participation

Five AOPA members will receive complimentary registrations for the 2008 National Assembly at the Chicago Hyatt Regency, Sept. 10-13 for participating in the AOPA Member Survey. Of the 297 members participating, 120 sent a postcard or e-mail indicating their participation which made them eligible for the drawing conducted by Industry Insights, AOPA’s consultant on the survey project.

Industry Insights notified AOPA that the winners are:  Cascade DAFO Inc., Ferndale, WA; Colburn Orthopedics, Inc., Franklin, PA; Ingrid Frank Prosthetics, Inc., Natick, MA; Motion Medical, Pelham, AL; and Artisan Prosthetics, Phoenix, AZ.

Congratulations to these lucky winners but also a huge thank you from AOPA to all of the 297 members who invested their time in helping create a better AOPA and a better O&P industry to maximize future opportunities.

The survey disclosed five areas where members were in strong agreement. They strongly agreed that:

  • the cost of materials and labor will increase faster than fee schedule increases;
  • that payers’ concern is the cost of care; 
  • accreditation is a positive for the O&P profession; 
  • fee schedule increases will be difficult to secure in the future, and;
  • licensing is a positive benefit for the O&P profession.
When asked about exit plans, 25 percent of the respondents will pass their business on to a family member, 24 percent anticipate selling to a larger player, nine percent believe merging with a competitor is their solution, and six percent contemplate selling to another type of health care professional. Thirty-six percent do not have an exit plan.

Watch AOPA In Advance and the Almanac for more details on what members think and feel about their existing business and practice, their future and their view of AOPA information and services.  And don’t miss the special business session at the 2008 National Assembly which will delve more deeply into what the results tell us about the opportunities for future growth.

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

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Attention AOPA National Assembly Exhibitors

If you manufacture microprocessor knees or stance control KAFOs, we invite you to participate in a panel discussion during the 2008 AOPA National Assembly, Sept. 10-13 in Chicago. The purpose of each symposium is to educate practitioners on the specific aspects of these devices, such as how to appropriately match a device and a patient.

The 2008 Assembly Committee is dedicated to Taking the Chicago Assembly to New Heights; therefore, limitations apply to presentation content. No infomercials will be allowed. You may contact the organizers below for more specific information on the symposium. If you are interested in participating contact the organizers no later than Feb 29.

Michelle Hall, CPO, FAAOP at m_jhall@yahoo.com or (651) 638-4735 to participate in the Microprocessor Knee Symposium.

Russell J. Hornfisher at Hornfisher@aol.com or (734) 673-8366 to participate in the Stance Control Orthoses Symposium.

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

 

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Registration for AOPAversity in Las Vegas Now Open

Join us at Bally’s in Las Vegas April 17-18 for the first course in AOPA’s new educational experience, AOPAversity. The initial course, “Mastering Medicare: Advanced Coding and Billing Techniques,” takes up where our old Coding & Billing Seminar left off, covering new topics like appeals, compliance issues, documentation, complex coding and in-depth discussion of medical policies and how they affect billing. Meant for both practitioners and office staff, this advanced two-day event will feature break-out sessions for these two groups, to ensure concentration on material appropriate to each group.

Basic material that was contained in our previous Coding & Billing Seminar program will now be converted to nine one-hour Web casts. The first of these will be available this spring. Watch AOPA in Advance for further information.

The application is available here.

Questions? Contact Erin Kennedy at ekennedy@AOPAnet.org or (571) 431-0834. She can provide you with further information and a registration form.

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Office Depot and AOPA: Partnering for Success!

Take advantage of these negotiated deeper discounts, cost saving initiatives and
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.


Reminder: Medical Review Functions

Just a reminder that effective March 1, 2008 Medical Review (MR) functions will be transitioned from the Program Safety Contractors (PSC) to the DME MACS. This means that any information pertaining to Local Coverage Determinations (LCD), HCPCS, and MR Education will be located on the DME MAC Web sites.  The DME MACS will also become responsible for Comprehensive Error Rate Testing (CERT), Probe Reviews and Prepay/Post pay reviews.

Jurisdiction A: www.medicarenhic.com
Jurisdiction B: www.adminastar.com
Jurisdiction C: www.cignagovermentservices.com
Jurisdiction D: www.noridianmedicare.com

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

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New York Attorney General Sues Over Reimbursements

New York Attorney General Andrew M. Cuomo announced plans to sue the UnitedHealth Group and to subpoena 16 other insurers. According to the Washington Post, the reasons for these actions relate to “[an] investigat[ion] [of] reimbursement practices that allegedly cheated customers out of hundreds of millions of dollars.” He is suing over practices that limit payments by insurers claiming medical charges were unreasonably high.  The Attorney General charged that a six month investigation showed Ingenix, a subsidiary of United Health, has a “defective and manipulated” database that most health insurance companies use to set reimbursement rates for out-of-network expenses which “dramatically under-reimbursed” patients.  Among the insurers to be subpoenaed are Aetna, Cigna, Empire Blue Cross & Blue Shield and Humana.

United Health said it is cooperating with Cuomo’s office and defended the data from Ingenix noting that it “is rigorously developed, geographically specific, comprehensive and organized using a transparent methodology that is very common in the health industry.”

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

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O&P Resources from AOPA
2008 Audio Conference Schedule Announced
 
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 conferences 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 the equipment 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 professionals use these sessions as a cost-efficient, time-efficient means of training supervisors, managers, and 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 CEs; further details on obtaining CEs 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.
 
 
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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.


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 more 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 favored 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.

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 to order or to see a complete list of available topics.

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

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AOPA 2008 National Assembly to Be Held in Chicago: Your Kind of Town

While the AOPA National Assembly will keep you busy with the best in business and clinical education programming, as well as the nation’s largest O&P trade show, take some time to get out and experience all that Chicago has to offer! What’s your pleasure? From fabulous restaurants and fantastic shopping, to world class art, theatre, and architecture, to championship sports teams and river boat cruises, Chicago offers something for everyone.

In Chicago, you can…
  • Catch the White Sox at Comiskey Park or see the Cubs play at Wrigley field;
  • Enjoy the view from the top of the Sears Tower or the Hancock Observatory;
  • Shop ‘til you drop on Chicago’s famed Magnificent Mile;
  • Dine at one of Chicago’s five-star restaurant, or grab some of the city’s famous deep-dish pizza;
  • Take in a show at Steppenwolf, the Goodman, the Broadway Theatre, or any of Chicago’s many theatres;
  • Reflect on “American Gothic,” “Nighthawks” or “Sunday Afternoon,” at the Art Institute of Chicago
…and so much more! Click here for a sneak preview of Chicago attractions!

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

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O&P Insider's Track
The Only Up-to-the Minute O&P Newsline
People In the News

This week, Touch Bionics announced a series of hires: Bill Graham has been named U.S. sales manager for the eastern division of Touch Bionics; Tim Stevens has been named U.S. sales manager for the western division of Touch Bionics; Gaurav Mishra has joined Touch Bionics as director of international business development, and; Fiona Macintyre has been appointed marketing manager and will be responsible for implementing the company’s U.S. marketing strategy. In addition, Derek Smith has joined Touch Bionics as senior mechanical engineer, while Fred Tatlow has joined the company as a mechanical engineer.

John F. Schulte
, CPO, FAAOP has joined the Fillauer Companies, Inc. of Chattanooga, Tennessee and will work there as a Clinical Educator.

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Businesses In the News

Sampson's Prosthetic & Orthotic Laboratory, a full-service provider of custom-fit and fabricated orthotic and prosthetic devices for people with a variety of physical disabilities, has relocated its Glens Falls office to a new patient care center at Adirondack Rehabilitation Medicine in Queensbury, NY.

 

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Send Us Your News!

The next AOPA in Advance will arrive in your inbox on March 4. 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