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No Bias, No Bull:
Stock and Bill Programs


Over the last several years there has been a surge in the number of stock and bill programs as well as a rise in participation. Doctors across the country have seemingly increased utilization in these third party providers for a multitude of reasons.

According to most physicians and office managers:

  • Practices have struggled to receive adequate reimbursement from medicare and private insurance companies
  • Third party programs offer ease and convenience to the practice and its employees
  • Outside vendors use of electronic billing streamlines operations
  • Supply companies provide generous consignment of DME products

However, stock and bill programs carry significant risks:

  • There are liability issues regarding product selection, fitting and instruction
  • Potential gray areas with medicare exist regarding L-Code billing which inherently includes the time for fitting and adjustment which may have not been performed
  • Insurance validation and financial concerns relative to non-insured patients, co-pays and discrimination policies
  • Limitations on physicians DME supply, potentially to a single manufacturer
  • Restrictions on the most cost-effective and appropriate products for patients• Many legal issues exist as well surrounding:
  • Anti-kickback statue
  • Stark law
  • Medicare supplier standards
  • Consignment closets

Ultimately, the reason these third party programs exist is simple, there is significant profit and financial remuneration for DME products. Outside vendors capitalize on many practices’ insurance coding and billing challenges as well as their reimbursement struggles and inability to track profits; typical DME reimbursement far exceeds the cost per product. All products provided by Smart Medical, Inc. offer a suggested L-Code. These codes are recommended by the regulatory and compliance departments of our manufacturing partners and subsequently authenticated by Smart Medical, Inc. We also provide a reimbursement table with both suggested minimum and maximum values for each product. This allows every physician and each practice to make a truly linear correlation between the cost of the prescribed DME product and its potential reimbursement value.

“Outside vendors capitalize on many practices’
insurance coding and billing challenges as well
as their reimbursement struggles and inability
to track profits; typical DME reimbursement far
exceeds the cost per product. ”

It is very important for both physicians and office managers to educate themselves on DME products, coding and invoicing. Patients are the lifeblood of every practice and their wellbeing is at the forefront with the ultimate responsibility falling on their doctors. Finding the right DME provider, the appropriate product and maximizing patient outcomes is our promise as your partner.

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