Tag: Dan Fedor
Accessories just got easier to bill
April 11, 2025Liz Beaulieu, Editor
WASHINGTON – CMS’s decision to revise and expand E1028 (swing-away mounting hardware) and create three new HCPCS codes based on where it's being used on a wheelchair is a "win” for the industry because it will make it easier for providers to bill for these devices, says Dan Fedor.
Fedor, director of reimbursement and education for U.S. Rehab, says the changes, which went into effect for dates of service on or after April 1, mean that, for the most common...
Bill would clear ‘major issue’ for high-tech wheelchairs
September 29, 2023Liz Beaulieu, Editor
WASHINGTON – A new bill in the U.S. House of Representatives would allow Medicare beneficiaries to pay the difference to upgrade to a titanium or carbon fiber manual wheelchair.
Right now, if a consumer wants a titanium or carbon fiber manual wheelchair, they must pay for the full cost of the wheelchair out of pocket, have their provider file a non-assigned claim on their behalf and, if approved, wait to receive 80% of the Medicare allowable.
“These numbers aren’t...
Repairs: A ‘good win’ but more to do
February 2, 2023Liz Beaulieu, Editor
YARMOUTH, Maine – Complex rehab stakeholders could start using a “basic order for repair” on Jan. 1 to meet Medicare’s requirement to show continued need.
Previously, Medicare required that providers show continued need in the medical record within 12 months of a repair.
“This is huge,” said Dan Fedor, director of reimbursement and education for U.S. Rehab, a division of The VGM Group. “This means an order covers repairs and continued need...
Stakeholders prepare response on PMD repairs
July 22, 2022Liz Beaulieu, Editor
WASHINGTON – Industry stakeholders believe a recent Office of Inspector General report on repairs for power mobility devices is “disingenuous.”
The report’s title claims Medicare improperly paid DME suppliers an estimated $8 million of the $40 million it paid for power mobility device repairs between Oct. 1, 2018, and Sept. 30, 2019.
“The report is very concerning,” said Seth Johnson, vice president of government affairs for Pride Mobility...
OIG report ‘exposes’ Medicare Advantage
July 1, 2022Liz Beaulieu, Editor
YARMOUTH, Maine – The OIG’s recent finding that some Medicare Advantage plans are delaying or denying access to services shines a light on “one of the most financially damaging things happening to HME providers right now,” says Dan Fedor.
“It’s really ugly what’s happening,” said Fedor, director of reimbursement and education for U.S. Rehab, a division of the VGM Group, who has been known to call Medicare Advantage “Medicare Disadvantage.”
Here’s...
Repair issues at ‘overflow point’
June 10, 2022Liz Beaulieu, Editor
YARMOUTH, Maine – Complex rehab stakeholders are amplifying their efforts to resolve issues around repairs, with right-to-repair bills being introduced in more and more states and one recently approved in Colorado.
These bills, which can vary from state to state, typically allow consumers to buy parts directly from manufacturers and repair their own equipment.
“It was bubbling up before the pandemic and supply chain issues, and it’s an overflow point now,” said Dan Fedor,...
FMA is ‘proof’ of benefits, U.S. Rehab says
November 19, 2021Liz Beaulieu, Editor
WASHINGTON – Recent virtual meetings with legislators highlight the importance of leveraging the Functional Mobility Assessment tool to show the value of appropriate seating and mobility equipment, say U.S. Rehab’s Dan Fedor and Greg Packer.
During those meetings, which took place as part of the Virtual CRT Congressional Fly-in on Sept. 21, legislators asked for “proof” that power standing devices and other complex rehab equipment benefit...
Is Medicare Advantage too good to be true?
December 29, 2020Liz Beaulieu, Editor
In November, at the height of open enrollment season, U.S. Rehab’s Dan Fedor warned complex rehab providers about the Medicare Advantage plans that were being promoted by celebrities in TV commercials.
The first thing providers need to know about these plans: what they’re promising Medicare beneficiaries.
“A lot of (MA plans) are trying to lure (beneficiaries) from traditional Medicare to their MA plan,” said Fedor, director of reimbursement and education for U.S. Rehab,...
SWO alleviates confusion for PMDs
February 6, 2020Liz Beaulieu, Editor
WASHINGTON - Providers of power mobility devices have perhaps the most to gain from a new standard written order that went into effect Jan. 1, stakeholders say.The SWO replaces four types of orders, including the seven-element order, which was a sticking point particularly for PMD providers.“Some providers were sending me thumbs up emojis when I told them about the SWO,” said Dan Fedor, director of reimbursement and education for U.S. Rehab, a division of the VGM Group.The elimination...
Q&A: VGM's Buhrmester & Fedor
August 28, 2017Liz Beaulieu, Editor
WATERLOO, Iowa - Just when HME providers think they have control over documentation and billing, Medicare throws them a curve ball. That makes it difficult for them to develop good habits—a big reason why they're turning up for The VGM Group's “Breaking Bad Reimbursement Habits” tour. Here's what Ronda Buhrmester and Dan Fedor, two reimbursement specialists for VGM who are running the tour, had to say in April about how providers are getting themselves on the right path to reimbursement.HME...