On February 1, 2011, Wright & Filippis, along with several other Michigan medical equipment providers
decided to not participate with the Michigan Medicaid and Children’s
Special Healthcare Services (CSHCS) Programs for the provision of
complex rehab products. There were policy changes at Medicaid that
prompted us to make this difficult and unprecedented decision. Since
that decision, we have been meeting with representatives from Michigan
Medicaid in hopes of resolving these issues. After 3 months of these
negotiations, we can again participate with Michigan Medicaid and
Children’s Special Healthcare Services for the provision of
rehabilitation and mobility/seating equipment, effective immediately.
I finally have some
good news to share with you. The key issues under discussion have been
resolved through these negotiations and will certainly have a positive
impact on the patients that we both
serve. Policy has been clearly defined and should eliminate the need
for resubmission of prior authorizations that are frustrating to not
only you and the patient, but to the vendors as well. Items that have
always been able to be billed-for, will again be able to be provided,
and not at a loss to the vendor (ie: bus tie-down brackets, for
example). And the allowable for non-coded/NOC (ie: bath chairs, car seats, etc.) items have been given a more realistic reimbursement amount, so we can continue to provide appropriate, functional, and quality products for your patients.
Some things, however, have not changed. We are still required to fill out the 1656 form (the 11 page form) for mobility and seating items as well as standers. These have to be filled-out in their entirety, with accurate and relevant information. This is best accomplished by having both yourself, to address the clinical issues, as well as myself to address the equipment concerns. Please contact Angie Osborn at the Grand Rapids Office to arrange for a scheduled appointment.
We will still have to be conscious of the limits allowed for the various items you are requesting. Wright & Filippis will continue to make every effort to provide the very best equipment to accomplish the outcomes we expect, while still being profitable. I don’t anticipate any problem with fulfilling your patient’s needs and staying within that framework.
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