tci Medicare Compliance & Reimbursement - 2011 Issue 15
Part B Mythbuster: Buying Equipment? Ensure Medicare Reimbursement First
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Article Overview
This article discusses the importance of checking payer coverage and reimbursement details before buying new medical equipment or technology. It focuses on the role of Medicare contractors/MACs, the need to verify coding and policy requirements directly with payers, and the broader implications for practices that also bill private insurers, Medicaid, and workers’ compensation payers. The article is aimed at practices considering capital equipment purchases and at coding or billing staff who help confirm whether a technology is likely to be payable under current policy.
Why This Topic Matters
Equipment purchases can create financial risk if reimbursement assumptions are wrong. Verifying coverage, code selection, and policy requirements in advance helps practices avoid denied claims and unexpected costs.
What You Will Learn
- Why reimbursement should be confirmed before purchasing new equipment
- How payer coverage policies can differ across Medicare and other insurers
- Why manufacturer guidance should be verified with the payer directly
- What kinds of policy and documentation checks may affect payment
- How coding research fits into equipment purchasing decisions
Who Should Read This
- Medical practice owners
- Practice administrators
- Billing staff
- Coding professionals
- Healthcare managers
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