Current Pedorthics March-April 2016 | Vol.48, Issue 2 - Page 43

DOES DOING YOUR HOMEWORK PAY OFF? start a patient to see if you can even complete the services. Accountable Care Organizations are the next new thing to make our lives more difficult. Essentially, it is a network within a network. Practices that are using the ACO model will require you to be part of their internal network. Another new concept is the Dual Eligibles program. This is supposedly a seamless Medicare/Medicaid program that “simplifies” billing to a Medicaid contractor that processes the claims and produces one reimbursement check for both programs. This currently is in place in three states, my own of Ohio being one of them. Advertised as cost saving program where both government entities get together to provide a cohesive care plan for dual eligible beneficiary, in Ohio, it turned out to be a nightmare for providers. Two days before New Year’s the state Medicaid department send out an email entitled “general information for Medicaid providers” that turned out to be nothing of the sort. Most providers don’t read these “general information” messages as they usually are just this side of spam. This one was not. It informed everyone that effective January 1 that Ohio would no longer be covering deductibles and copays for certain professions, ours included. Then we come to find out that the “reimbursed at Medicare allowable” meant sixty-five " Accountable Care Organizations are the next new thing to make our lives more difficult. " Current Pedorthics March/April 2016 41