I have no experience with LC problems but let me tell you alittle about how
hospitals do bill form my experience with the different departments of our
hospital and inpatient and outpatient issues.  These may vary somewhat state
by state too. Our physical therapy department cannot do home assessments and
treatments directly, they do these things but they have to have a contract
with the Public Health Nurses who are liscenced to deliver care in the home.
 They assess the pateint and then contract with the PT department to give the
services.  ANother story about the PT department, They use to RENT crutches
to people so they could use them the short time they needed and then return
at less cost.  The hospital insurance carrier put a stop to that as they felt
there was too much liability in used equip. so now everybody gets brand new
ones at more cost.(Of course the insurance pays for it so the patient rarely
complains, I always ask if they have any at home or can borrow some.)
Our hospital pharmacy cannot fill presriptions for home use.  We can give
meds(read put into there mouth) in the ER and if we come to see the patient
they can reive a three day supply from the hospital to use at home but people
cannot get their two week supply.  They have to go to the OUTPATIENT pharmacy
to have the sript filled.
I can see where the hospital doesn't have in place a system to charge for
rental equipment. I am less understanding they they are unwilling to create a
system.  One of my big pet peeves is when people say "I can't" when they
really mean, "I choose not to."  The hospital could become a rental station
in theory but I think they would jack the price up so much that it would be
too high.  What MIGHT work is for you to have a contract with the hospital to
provide LC services, the hospital pays for the services to the patient, but
then you bill seperatly for anything else that you provide pumps, creams ,
bags, etc.  Your contract with the hospital would reflect the arrangement
that you have the permisson to do this.  A simple sales contract with the
patient where they sign an acknowledgement that these items are not billed
through the hospital, are not payable from insurance, and are the
responsibility of the patient should help clarify that to the patient.  The
model for this is the xray department of the hospital.  There is a fee from
the hospital for the use of the room, the film, the tech time etc., then
there is a seperate bill from the radiologist for his professional services.
 ONE SERVICE TO THE PATIENT, TWO BILLS FROM SEPERATE PARTIES.
LC services are still in their infancy in hospitals relatively speaking so it
will take some time for the two parties to learn how to dance without
stepping on each others toes.


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Jon Ahrendsen, MD, FAAFP, LLLI Medical Associate *
215 13th Ave, SW                                                    *
Clarion, Iowa, 50525  USA                                        *
phone 515-532-2836                                                 *
Fax 515-532-2523                                                    *
Email [log in to unmask]                                           *
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