TENS Increase Your Profit Margin?

Advertisements are being sent to doctors via facsimile in various parts of the United States from a California company asking them if TENS/EMS units are presently being prescribed to patients for home use? If not, this company reports that they can show how to give patients drugless pain relief and add a new profit center to the doctors office with TENS/EMS.

The company says their program is simple - they sell TENS to doctors for $29.00 (when 2 or more are purchased) EMS for $38 (when 2 or more purchased) and instruct the doctor on billing procedures for the TENS and fitting fee where the profits range from $200.00 to $600.00 per unit depending on the type of insurance coverage and amount charged for the unit/fitting fee. Next, the company indicates that they provide the patient with necessary supplies (batteries, pads & wires) and will bill the insurance company direct.

Good deal? Maybe.

Many state regulatory boards have prohibitions against excessive charges for health care services rendered - could the billing insurers $200 to $600 for providing a patient with a TENS the doctor purchased for $29 be considered excessive? What would the involved payer think of this activity - are they going to knowingly pay $200 to $600 for your providing the patient with a $29 TENS unit? And, what happens when insurance doesn't pay - is the patient going to be billed the higher rates for the $29 unit?

I would recommend that doctors ensure that this practice activity is consistent with their administrative laws, third-party payer rules and to check it out first with their attorney prior to use.

Daniel J. Osborne, M.S., is a renowned expert on health care fraud issues and recognized authority on health care compliance. He can be contacted at Chiropractics Compliance Consultants, Inc., 18065 238th Street,Tonganoxie, Kansas 66086, 913-369-9000, http://www.cccpfc.com

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