Thank you for your support and referrals.
Medicare recently changed their coverage determination process for prosthetics. They now require additional physician documentation to provide coverage.
These regulations started in August 2011, with the "Dear Physician Letter" which states that
- "The treating physician's record, not the prosthetist's are used to justify payment"
- "The records must document the patient's current functional capabilities and his/her expected functional potential, including an explanation for the difference"
Medicare also requires that the prescribing physician's records collaborate the prosthetist's findings and recommendations, and without this information will deny coverage even after prosthetics service are provided.
Medicare requires the notes be no more than 6 months old, be legible, contain an original legible signature, they will not accept signature stamps of any kind.
To assist you, we have included below a downloadable outline of the information that Medicare requires. Please incorporate this information into your report and send us a copy, so we can begin treatment.