WELCOME WELCOME ““Medicare & Medical Supplies” Medicare & Medical Supplies”

What you need to know..What you need to know..

First Choice MedicalFirst Choice MedicalEquipment & SuppliesEquipment & Supplies

Presented by Jay BuinickyPresented by Jay Buinicky

AgendaAgenda

• Who is First Choice Medical Supply• Medical Products & Services• Competitive Bidding• Face-to-face Requirement• Personal Emergency Response Systems• Diabetic Shoe Program• Questions

Who is First Choice Medical?Who is First Choice Medical?

• Home Medical Equipment Provider (HME or DME)• Provide the highest quality and most reliable medical

equipment products & services• Committed to helping people with their comfort &

mobility needs • Subcontractor for the Competitive Bidding program• Accredited Medicare & Medicaid Provider • Over 16 years of industry experience• Local Retail Store Front (Downtown Matthews)

Our Mission StatementOur Mission StatementFirst Choice Medical is committed to being a leading

provider of high quality and reliable medical equipment products with a professional and

courteous approach to customer service.

We gladly offer the following servicesWe gladly offer the following services

• Direct Billing to Medicare & Medicaid (Provide latest info.)• Convenient Retail Showroom in Matthews (Hours 9-5, Mon-Fri)• Prepare Proper Documentation (We work with your doctor)• FREE Delivery & FREE Setup of Equipment (Same or next day)• Provide Product and Safety Education (On-site education)• Service & Repair Everything We Provide (Yearly maintenance)• Rental Equipment Available• Service Mecklenburg, Union, Cabarrus, Gaston, Catawba, Lincoln, Iredell, Lancaster, and York county

• Direct Billing to Medicare & Medicaid (Provide latest info.)• Convenient Retail Showroom in Matthews (Hours 9-5, Mon-Fri)• Prepare Proper Documentation (We work with your doctor)• FREE Delivery & FREE Setup of Equipment (Same or next day)• Provide Product and Safety Education (On-site education)• Service & Repair Everything We Provide (Yearly maintenance)• Rental Equipment Available• Service Mecklenburg, Union, Cabarrus, Gaston, Catawba, Lincoln, Iredell, Lancaster, and York county

Mobility is our Specialty Mobility is our Specialty

Mobility AidsMobility Aids• Canes / 4 Prong Canes• Standard Walkers• Rollator Walkers• Manual Wheelchairs

(rental)• Motorized Wheelchairs• (rental)• Scooters• (rental)

*5 Year Rule*

Other ProductsOther Products• Hospital Beds / Bed Rails• Gel/Air Mattresses• Patient Lifts / Transfer Aids • Trapeze Bars / Assist Rails• Lift Chairs • Diabetic Shoes • Bariatric Equipment 500 lbs.• Wheelchair Cushions /

Accessories• Lifts / Carriers / Ramps• Personal Emergency Alert

Systems• And Much More!

Bath SafetyBath Safety

• Raised Toilet Seats• Commode Chairs• Bath/Shower Chairs• Transfer Benches• Grab Bars• Tub Rails• Hand Held Shower Heads• Bath Lifts

* Medicaid covers cost for most items

Incontinence SuppliesIncontinence Supplies

NC Medicaid covers the cost for:•Adult Briefs/Pull ups – 200 qty. per month•Under pads – 150 qty. per month•Requires Rx from physician

Pain ManagementPain Management• Arthritic Pain Relief• Back Braces• Knee Braces• Ankle Braces• Wrist Braces• Elbow Braces• T.E.N.S Units (Electro Therapy)

Wide-range of applications:• Arthritis• Herniated Discs• Lower Back Pain• Knee Pain• Edema (Swelling)• Muscle Pain or Cramps• Chronic and Acute Strains• Post-Surgical Recovery &

Stabilization• Bulging Discs• Degenerative Disc Disease• Functional Mobility

Medicare’s Competitive Bidding Medicare’s Competitive Bidding Program?Program?

BackgroundIn 2003 a law was passed that required Medicare to solicit bids from companies that provide home medical equipment. The purpose was to change the way the reimbursement for each item is calculated. Currently, the reimbursement for each item is arrived at by a fee schedule that is approved by Congress. The goals of the new system are to have the market set the pricing through a bidding program, and reduce costs to the Medicare program.

The result of the program is that bid winners are selected and offered contracts. Those companies who are awarded contracts are the only providers who can fill orders for Medicare beneficiaries (after 1/1/2011)

What is the Medicare Competitive What is the Medicare Competitive Bidding Program?Bidding Program?

• Started in January 2011 in Nine cities across the US • July 2013 in 99 Cities across the US (Next 3 years – entire US)• Qualified, accredited suppliers with winning bids are chosen as

Medicare-contract suppliers -3 Year Bid• Helps Medicare save money (saved $202 Million in round 1)• Estimated Medicare savings of $25.7 billion 2013 - 2022• Helps limit fraud and abuse in the Medicare Program• Does not apply to Medicare Advantage Plans (example HMO or PPO)• Medicare still pays 80%• Moving/Traveling – based on Zip code• Sub-contracts are available

What is the (DME) Competitive What is the (DME) Competitive Bidding Program?Bidding Program?

• Walkers• Wheelchairs• Motorized Wheelchairs• Hospital Beds• Support Surfaces• Oxygen Equipment• CPAP, BiPAP & Supplies• Enteral Nutrition• Negative Pressure Wound Therapy• Diabetic Shoes/Diabetic Supplies* More items in the future

(DME) Competitive Bidding Items?(DME) Competitive Bidding Items?

• Walkers *• Wheelchairs *• Motorized Wheelchairs *• Hospital Beds *• Support Surfaces *• Oxygen Equipment• CPAP, BiPAP & Supplies• Enteral Nutrition• Negative Pressure Wound Therapy• Diabetic Shoes/Diabetic Supplies ** YES we can provide

Subcontracting for Competitive Subcontracting for Competitive Bidding Items?Bidding Items?

Local Bid AreaLocal Bid Area

www.dmecompetitivebid.com – Zip Code List

www.GetDME.com

Confused yet?

Questions?

““Face-to-face Encounter Face-to-face Encounter Requirement”Requirement”

Face-to-face Encounter Product ListFace-to-face Encounter Product List

• Walkers• Wheelchairs• Motorized Wheelchairs• Hospital Beds• Low Airloss Mattress• Oxygen Equipment• CPAP, BiPAP & Supplies• Diabetic Shoes• Diabetic Supplies

Face-to-face Encounter RequirementFace-to-face Encounter Requirement• The face-to-face encounter conducted by the

physician, PA, or NP must document that the beneficiary was evaluated and/or treated for a condition that supports the item(s) of DME ordered.

• In the case of a DME ordered by a PA or NP, a physician (MD or DO) must document the occurrence of a face-to-face encounter by signing/co-signing and dating the pertinent portion of the medical record.

• The beneficiary’s name; • The DME item ordered; • The prescribing practitioner’s National

Provider Identification (NPI); • The signature of the prescribing practitioner;

and,• The date of the order.

Detailed Written OrderDetailed Written Order

• Physician’s Name;• Start date of the order (if different from the date of the order);• Signature date personally entered by the ordering practitioner;• Dosage or concentration, if applicable;• Route of administration, if applicable;• Frequency of use;• Duration of infusion, if applicable;• Quantity to be dispensed; and• Number of refills, if applicable.

Also can include…Also can include…

Diabetic Footwear ProgramDiabetic Footwear Program Medicare “Therapeutic Shoe Bill” for Medicare “Therapeutic Shoe Bill” for

DiabeticsDiabetics– May 1, 1993 Medicare past the Therapeutic Shoe Bill – Shoes help prevent foot problems among Diabetic patients– Therapeutic footwear and protective insoles provide protection

that helps reduce callusing which can lead to ulcerations – Protective footwear can help in the fight to prevent the 54,000

diabetic amputations that occur each year – Under their Therapeutic Shoe Bill benefits, the patient receives

one pair of Diabetic Shoes and three pair of Protective Inserts once every calendar year

19931993

Shoes have Shoes have come along come along

way!way!

20142014

Personal Emergency Response System (PERS)Personal Emergency Response System (PERS)Alert Sentry

Benefits & Features:

• 24 Hour Monitoring (Up to 500 Feet Range)• Speaker Phone (2-Way Communication)• Battery Back Up (80 Hours of Standby Power• Waterproof Help Button• FREE Shipping & Activation • No Contracts (Cancel Anytime)• Must Have Home Phone Line• 30 Day-money back guarantee

Personal Emergency Response System (PERS)Personal Emergency Response System (PERS)

iSAFE Mobile Responder

Benefits & Features: $ 29.95• Two-way voice communication using powerful microphone and

speaker to ensure call quality.• Small, Lightweight and Shower-safe. Wearable• Nationwide coverage• Cellular Location Technology allows Response Center to notify the

proper authorities and your personal responders as to the area your located.

The iSAFE Mobile Responder, unlike a cell phone, is:• Shower-Safe• Last two months on a single charge• Performs a daily battery test• Provides low battery notification via email or text

The iSAFE Response Center, The iSAFE Response Center, unlike 911, Knows:unlike 911, Knows:•Who You Are – Name, Home Who You Are – Name, Home Address, Age, etc.Address, Age, etc.•Where you areWhere you are•What you're drivingWhat you're driving•Who your family and friends are Who your family and friends are that you want contactedthat you want contacted•No landline phone connection or No landline phone connection or base station required.base station required.•No Contracts (Cancel Anytime)No Contracts (Cancel Anytime)•No Home Phone RequiredNo Home Phone Required

https://www.youtube.com/watch?v=ezOT6IdJk9Y

SAFETY FOR YOUR ACTIVE LIFESTYLE

Get Help… Anytime, Anywhere!

iSAFE Mobile Responder Video Click on Video Below!

SummarizeSummarize Here to help with your Comfort & Mobility needs “Consultants” not sales people Subcontractors to provide most equipment Local phone call away Questions?

(704) 821-7777 Fax (704) 821-1012

Jay Buinicky, Director of Sales & Marketingjay@FirstChoiceMedical.com

www.FirstChoiceMedical.com