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. *************************************************************** 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] * ***************************************************************