May 2011 O&P Almanac

Almanac OP The American Orthotic & Prosthetic Association

MAY 2011

&

WWW.AOPANET.ORG

THE MAGAZINE FOR THE ORTHOTICS & PROSTHETICS INDUSTRY

MARKETING

STRATEGIES

FOR A NEW BUSINESS CLIMATE Times are changing, and so should the technologies you use to attract patients

PRACTICAL IDEAS for Expanding Your Facility HOW TO NAVIGATE LCD and PA Information

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O&P Almanac MAY 2011, VOLUME 60, NO. 5

CONTENTS

DEPARTMENTS

COVER STORY

20

Marketing Strategies for a New Business Climate

By Anya Martin Establishing your brand is critical for attracting new business, but what worked five or 10 years ago may not now. Discover how several established O&P companies tapped affordable new media resources as well as some reliable methods to bring in new patients.

4

AOPA Contact Page How to reach staff

8

At a Glance Statistics and O&P data

10

In the News Research, updates, and company announcements

40

AOPA Headlines News about AOPA initiatives, meetings, member benefits, and more

48 Marketplace

Products and services for O&P

FEATURE

30 Extreme Makeover

E

tr MAx K eme O&P EOV EDIT ER IO

N O&P Edition

By Jill Culora To stay ahead of the rapidly changing landscape, O&P professionals are making over the business. Facility owners have changed not only their buildings, but their entire care models to better serve patients and outshine the competition.

54 Jobs

Opportunities for O&P professionals

60 Calendar

Upcoming meetings and events

63

Ad Index

64

AOPA Answers

Expert answers to your FAQs

COLUMNS

16

Reimbursement Page Tips for using Medicare’s LCDs and PAs to find information quickly

O&P Almanac (ISSN: 1061-4621) is published monthly by the American Orthotic & Prosthetic Association, 330 John Carlyle St., Ste. 200, Alexandria, VA 22314; 571/431-0876; fax 571/4310899; email: almanac@AOPAnet.org. Yearly subscription rates: $59 domestic; $99 foreign. All foreign subscriptions must be prepaid in U.S. currency, and payment should come from a U.S. affiliate bank. A $35 processing fee must be added for non-affiliate bank checks. O&P Almanac does not issue refunds. Periodical postage paid at Alexandria, VA, and additional mailing offices. Postmaster: Send address changes to: O&P Almanac, 330 John Carlyle St., Ste. 200, Alexandria, VA 22314. For advertising information, contact Dean Mather, M.J. Mrvica Associates Inc. at 856/768-9360, email: dmather@mrvica.com.

MAY 2011 O&P ALMANAC

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OP Almanac

AOPA CONTACT INFORMATION

&

AMERICAN ORTHOTIC & PROSTHETIC ASSOCIATION (AOPA) 330 John Carlyle St., Ste. 200, Alexandria, VA 22314 AOPA Main Number: 571/431-0876 AOPA Fax: 571/431-0899 www.AOPAnet.org

EXECUTIVE OFFICES

MEMBERSHIP AND MEETINGS

Thomas F. Fise, JD, executive director, 571/431-0802, tfise@AOPAnet.org

Tina Moran, CMP, senior director of membership operations and meetings, 571/4310808, tmoran@AOPAnet.org

Don DeBolt, chief operating officer, 571/431-0814, ddebolt@AOPAnet.org O&P ALMANAC Thomas F. Fise, JD, publisher, 571/431-0802, tfise@AOPAnet.org Josephine Rossi, editor, 703/914-9200 ext. 26, jrossi@strattonpublishing.com

Tom Wessel, director of business development, 651/724-8753, twessel@AOPAnet.org Kelly O’Neill, manager of membership and meetings, 571/431-0852, koneill@AOPAnet.org Steven Rybicki, communications manager, 571/431-0835, srybicki@AOPAnet.org

PUBLISHER Thomas F. Fise, JD EDITORIAL MANAGEMENT Stratton Publishing & Marketing Inc. ADVERTISING SALES M.J. Mrvica Associates Inc. DESIGN & PRODUCTION Marinoff Design LLC PRINTING United Litho Inc.

BOARD OF DIRECTORS OFFICERS President Thomas V. DiBello, CO, FAAOP, Dynamic O&P, a subsidiary of Hanger Orthotic and Prosthetics Inc., LLC, Houston, TX

Michael Chapman, coordinator, membership operations and meetings, 571/431-0843, mchapman@AOPAnet.org

President-Elect Bert Harman, Otto Bock Health Care, Minneapolis, MN

Dean Mather, advertising sales representative, 856/768-9360, dmather@mrvica.com

Ann Davis, office, meetings administrator, and associate editor, AOPA in Advance, 571/431-0876, adavis@AOPAnet.org

Treasurer James Weber, MBA, Prosthetic & Orthotic Care, Inc., St. Louis, MO

Steven Rybicki, production manager, 571/4310835, srybicki@AOPAnet.org

AOPA Bookstore: 571/431-0865

Catherine Marinoff, art director, 786/293-1577, catherine@marinoffdesign.com

Ann Davis, staff writer, 571/431-0876, adavis@AOPAnet.org Teresa Tobat, editorial/production assistant, 703/914-9200 ext. 33, ttobat@strattonpublishing.com

GOVERNMENT AFFAIRS Kathy Dodson, senior director of government affairs, 571/431-0810, kdodson@AOPAnet.org Devon Bernard, manager of reimbursement services, 571/431-0854, dbernard@AOPAnet.org Joe McTernan, director of coding & reimbursement services, education & programming, 571/431-0811, jmcternan@AOPAnet.org Reimbursement/Coding: 571/431-0833, www.LCodeSearch.com a

AMERICAN ORTHOTIC & PROSTHETIC ASSOCIATION SERVING THE O&P FIELD FOR OVER 90 YEARS

Renew the Easy Way With AOPA ONLINE PAY Login to pay your dues and update your membership directory information at:

www.aopanetonline.org/profile

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4

O&P ALMANAC MAY 2011

Vice President Tom Kirk, PhD, Hanger Orthopedic Group, Austin, TX

Immediate Past President James A. Kaiser, CP, Scheck & Siress, Chicago, IL Executive Director/Secretary Thomas F. Fise, JD, AOPA, Alexandria, VA

DIRECTORS Kel M. Bergmann, CPO, SCOPe Orthotics and Prosthetics Inc., San Diego, CA Rick Fleetwood, MPA, Snell Prosthetic & Orthotic Laboratory, Little Rock, AR Michael Hamontree, OrPro Inc, Irvine, CA Russell J. Hornfisher, Becker Orthopedic Appliance Co., Troy, MI Alfred E. Kritter, Jr., CPO, FAAOP, Hanger Prosthetics & Orthotics Inc., Savannah, GA Eileen Levis, Orthologix, LLC, Philadelphia, PA Anita Liberman-Lampear, MA, University of Michigan Orthotics and Prosthetics Center, Ann Arbor, MI

NEW! UPDATE MEMBERSHIP DIRECTORY INFORMATION ONLINE

Mahesh Mansukhani, MBA Ossur Americas, Aliso Viejo, CA Frank Vero, CPO, Mid-Florida Prosthetics & Orthotics, Ocala, FL Copyright 2011 American Orthotic and Prosthetic Association. All rights reserved. This publication may not be copied in part or in whole without written permission from the publisher. The opinions expressed by authors do not necessarily reflect the official views of AOPA, nor does the association necessarily endorse products shown in the Almanac. The Almanac is not responsible for returning any unsolicited materials. All letters, press releases, announcements, and articles submitted to the Almanac may be edited for space and content. The magazine is meant to provide accurate, authoritative information about the subject matter covered. It is provided and disseminated with the understanding that the publisher is not engaged in rendering legal or other professional services. If legal advice and/or expert assistance is required, a competent professional should be consulted.

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At a Glance

Profile of AOPA Members Revenue Sources Remain Steady…

Projected Sales Increasing…

Percentage of revenue generated per discipline 42%

Orthotics

46% 46% 6%

$1 to $2 million

3% 2%

Up to $1 million

1% 1%

2007

2010

91%

Percentage of facilities accredited by the ABC in 2010.

7.2

Average number of total certified practitioners in a single practice.

4.5 out of 5 The rating members gave AOPA’s coding advice.

Source: 2010 AOPA Membership Survey 8

$2 to $5 million

7%

Pedorthics

Other

More than $5 million

48%

Prosthetics

DME

Annual projected sales and billings

O&P ALMANAC MAY 2011

10% 16% 23% 23% 25% 31% 42% 30%

2007

2010

Percentage of AOPA primary members, affiliates, and suppliers/distributors/manufacturers who see the aging United States population as their biggest opportunity.

16.1

Average number of years members have been affiliated with AOPA.

24%

Percentage of AOPA primary members, affiliates, and suppliers/distributors/manufacturers who believe government regulation is the biggest threat to their business.

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In the News

Egyptians May Have Created First Prosthetic Devices

Greville Chester toe

Cairo toe

and shows considerable signs of wear.

While the Cairo toe, housed in the Cairo Museum in Egypt, features a simple hinge, a chamfered front edge, and a flattened underside.

Scientist Jacky Finch, of the University of Manchester in the United Kingdom, published an article in the medical journal the Lancet detailing how she had two volunteers, both missing their big toes, wear the prosthetics to test their functionality.

The volunteers wore the toes with replicas of Egyptian sandals.

No significant elevation in pressure under the foot was recorded for either toe, although both volunteers said they found the Cairo toe

particularly comfortable.

“My findings strongly suggest that both of these designs were capable of functioning as replacements for the lost toe and so could indeed be classed as prosthetic devices,” says Finch. “If that is the case then it would appear that the first glimmers of this branch of medicine should be firmly laid at the feet of the ancient Egyptians.”

Photos: The University of Manchester

B

y demonstrating how two ancient prosthetic toes helped Egyptian amputees walk, a researcher may have discovered the earliest known prosthetic devices.

Both toes, one of which was found attached to a mummy, date back to 600 B.C., predating the earliest known practical prosthesis, the Roman Capua Leg, by several hundred years. The Greville Chester toe, named after the collector who acquired it for London’s British Museum, is made from a papier maché crafted out of linen, glue, and plaster,

The human body can recognize a prosthetic arm as its own, according to scientists at the Karolinska Institutet in Stockholm who say the discovery may have new applications for designing O&P devices.

A total of 154 volunteers had a prosthetic arm placed next to their right arm and observed the device being touched as their real hands were touched simultaneously—creating the experience that the prosthetic hand was their own.

Scientists tested each participant’s physiological reaction—by measuring the degree of palm sweat—to a knife dangling over the prosthetic arm. The results showed participants had the same reaction to the knife regardless of whether or not it was dangling over their real or prosthetic arm.

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O&P ALMANAC MAY 2011

Photo: Henrik Ehrsson

Researchers Create Illusion of Having Third Arm

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In the News

Amputee Coalition Pushes Message in Times Square

Photo: Otto Bock

Research Enters Next Phase for Mind-Controlled Prosthetics

Each day, more than 500,000 people passing through New York City’s Times Square will see the Amputee Coalition’s limb loss awareness message on a streaming electronic billboard located at 47th and Broadway, next to Roxy Delicatessen. Images of amputees performing daily activities are shown to encourage viewers to visit the Amputee Coalition’s website (507aday.org) to take an online risk assessment and learn more about limb loss. The messages will stream four times per hour, 24 hours a day, through June.

12

O&P ALMANAC MAY 2011

A Washington University researcher recently completed a set of experiments refining the control of brain-computer interface—a technology that may eventually lead to the creation of brain-controlled prosthetic devices or neuroprosthetics.

For his next test, researcher Daniel Moran plans to use this device to teach a macaque monkey how to control a prosthetic arm through thought alone.

He recently built a 32-channel EECoG brain-computer interface, which comprises grids of disk-like electrodes that are placed inside the skull but outside the dura mater—a membrane that covers and protects the brain. The EECoG grid is small enough to fit with the sensorimotor cortex of the brain.

Moran will insert a chip into a macaque’s brain to test if the creature can learn to recognize a virtual arm as its own. Next, the thin, flexible grid will be placed under the same

TRANSITIONS

monkey’s skull and train the animal to control—through thought—a computational model arm. The virtual arm will have seven degrees of freedom, including rotation about the shoulder joint, flexion and extension of the elbow; pronation, and supination of the lower forelimb; and flexion, extension, abduction, and adduction of the wrist.

If this experiment is successful, Moran would like to connect his EECoG brain-computer interface to a new peripheral nerve-stimulating electrode he is developing with a colleague. By connecting these two devices, they will create a neuroprosthetic arm—a paralyzed arm that can move again because the mind is sending signals to peripheral nerves that stimulate muscles to expand or contract. Moran says he hopes this will one day allow those suffering from paralysis to control their limbs using just their minds.

PEOPLE IN THE NEWS

Mike Allen of Midland, Texas, assisted Rep. Tom Craddick (R-Texas, 82nd District) in filing a bill to help patients find providers in Medicaid directory.

Audrey Back has been promoted to regional sales manager for Otto Bock HealthCare’s East Coast region.

Mark Edwards of Otto Bock has been promoted to professional and clinical services director.

Todd Kuiken, director of the Center for Bionic Medicine and director of Amputee Services at The Rehabilitation Institute of Chicago, conducted research and has been featured on CNN’s health blog.

Jim Lagerstrom, CP, has joined the Fillauer Companies Inc.’s sales team as the Midwest sales manager.

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In the News NCOPE Approves Pedorthic Standards

The National Commission for Orthotic and Prosthetic Education (NCOPE) board approved the Standards and Guidelines for Accreditation of Educational Programs in Pedorthics at its March 15 meeting in Orlando.

TRANSITIONS

O&P ALMANAC MAY 2011

public comments on the draft curriculum.

The new standards are effective immediately for any new programs seeking accreditation, and all currently accredited programs will transition to the new standards by the end of 2012.

BUSINESSES IN THE NEWS

The American Board for Certification in Orthotics, Prosthetics, & Pedorthics Inc. (ABC) and the Board of Certification/ Accreditation International (BOC) are Cobble Stone Sponsors of the Amputee Coalition’s Paddy Rossbach Youth Camp for 2011, a five-day summer camp for children ages 10-17 who have lost an arm or leg or were born with limb differences. The Cobble Stone sponsorship represents a financial commitment of $5,000 to the camp’s programs and activities.

The ABC is now accepting applications for the 2011 Larry Lange Travel Fellowship Award. This award recognizes the outstanding practice/ education of a current or recent graduate of the National Commission for Orthotic and Prosthetic Education (NCOPE) orthotic/prosthetic residency program and provides the winner with the opportunity to enrich his or her education and development. Applications are due to NCOPE by June 1.

Advanced Orthopedic Designs hosted a golf tournament in San Antonio on April 22 to benefit “Veteran Outdoors,” a nonprofit 501(c)(3) corporation dedicated to taking wounded veterans on outdoor hunting and fishing trips.

14

The process for approval includes the creation of new certificate-level curriculum based upon the profession’s practice analysis and the results and recommendations of NCOPE’s April 2010 education meeting. I also includes the pedorthic community’s

Allard USA has formed a nonprofit organization, the DRALLA Foundation, to serve the different needs of individuals with physical disabilities and their families. This will include providing financial support for educational as well as for training programs that will help individuals pursue their dreams and sponsoring events that provide encouragement and support.

Lifeart Prosthetics Inc. received a $35,000 grant from the National Research Council of Canada for the continued research and development of breast prostheses.

Amputee & Prosthetic Center and Limbs of Love celebrated Valentine’s Day with 54-year-old amputee Debbie Rivera, who lost her right leg to diabetes in 2009. Rivera received a donated prosthetic device from both organizations.

Ohio Willow Wood announced that it has changed its name to WillowWood.

Bulow BioTech Prosthetics has opened a Columbia, South Carolina, clinic. This is the company’s first facility outside of Tennessee.

DJO Global has announced that one of its indirect subsidiaries has signed a definitive agreement to purchase Dr. Comfort for approximately $254.6 million.

Hanger Orthopedic Group has pledged $45,000 to the Amputee Coalition’s Bridge to Ability Fund throughout the next three years. This fund will provide scholarships to new amputees to attend the Amputee Coalition’s National Conference, June 1-4, in Kansas City, Missouri.

Northern Prosthetics and Orthopedic Inc. celebrated its 50th anniversary and has served the Northern Illinois/Southern Wisconsin area since 1961.

Orthotic & Prosthetic Group of America has partnered with the Kassel Group Inc. to present the Applied Technology Institute orthotic fitter school at a special tuition rate to its members.

Otto Bock HealthCare Canada was honored with the Corporate Award from The Canadian Foundation for Physically Disabled Persons. The award recognizes companies who have made an outstanding contribution in assisting persons with disabilities. Össur has selected Prosthetic Innovations LLC, as one of five certified facilities in the country for the new Power Knee.

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Reimbursement Page

By Devon Bernard, AOPA government affairs department

A Guide to the LCD/PA Medicare’s Local Coverage Determinations and Policy Articles provide a wealth of information

W

hile the basic tenets of what is covered

by Medicare are located in the Social Security Act, additional guidance about these benefits often is needed.

This information can be found in national Medicare policies called National Coverage Determinations (NCDs).

However, when there is not a national policy, as is the case for O&P, or when there is a need to further clarify a NCD, Medicare will create a local policy with input from the medical directors of each of its contractors, consultants, physicians, suppliers, and manufacturers.

Local policies consist of two separate but intertwined documents called Local Coverage Determinations (LCDs), which contain information about what is reasonable and necessary, and Policy Articles (PAs), which contain coverage information that is not related to medical necessity and the limitations of each benefit.

While each of the four DME MAC jurisdictions publishes its own LCDs and PAs on its websites, you also may find the LCDs and PAs on Medicare’s website, www.cms.gov/medicare-coveragedatabase, and the LCDs and PAs content will be identical.

Now that you know the basic intent of a policy and where to find them, how do you read and interpret them?

This installment of the Reimbursement

16

O&P ALMANAC MAY 2011

valuable information, but we will focus on four subsections that will be the most useful to you as you read an LCD to determine if an item/service is medically necessary and covered by Medicare and what is needed to submit a claim successfully.

Page will give you some hints on how to use these policies to find the most pertinent information quickly.

The LCD An LCD is divided into four sections: Contract Information (who published the LCD), LCD Information (when the LCD became effective), Coding Information, and General Information. These four sections are then subdivided into more specific and detailed subsections. Each of these sections and subsections contains

Indications and limitations of coverage and/or medical necessity. If you’re trying to determine whether a KAFO is covered or medically necessary for a non-ambulatory patient, this is the section to read. This section will inform you when and how an item or service is covered as a Medicare benefit.

This section also will identify what type of information you should be documenting to ensure that medical necessity coverage criteria have been met. For example, the Lower Limb Prosthesis LCD indicates that a prosthesis is covered if the patient desires to ambulate or use the prosthesis. So, your records should have some mention of the patient’s desire to use the prosthesis and ambulate.

The Knee Orthosis (KO) LCD provides another good, but more complex, example. If you are providing an L1845, the LCD clearly states that you must test for knee instability and document the results of these tests. If you simply state in your records that the patient has knee instability, your claim will be denied as not medically necessary.

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Reimbursement Page

Because items/services in this section are typically denied as not medically necessary, this section informs you when you may want to consider having a patient sign an Advanced Beneficiary Notice (ABN) and use the GA modifier, because an ABN should only be used when you believe an item will be denied as not medically necessary.

is only covered for a patient with a diagnosis of 713.5. However, other requirements in the LCD must be met in order for a custom AFO to be medically necessary and covered.

HCPCS codes and modifiers. This section is pretty straightforward. It tells you what modifiers, if any, must be used when submitting claims related to the products covered by the policy. If there are modifiers listed in this section, check to see whether your claim contains any of these modifiers; if it does not, the claim may be rejected.

This section also provides a list of procedure codes that are used when billing for the services related to the policy. Keep in mind that just because a code is listed, it is not an indication that it is a covered service.

ICD-9 codes that support medical necessity. This section lists the diagnosis codes that either support or do not support medical necessity and coverage. If you want to see whether a certain item, device, or service requires a specific diagnosis, check this section instead of searching the whole LCD. For example, does a patient require a diagnosis of amputation in order to receive a lower limb prosthesis? The answer is no.

Be aware that a listed diagnosis code used by itself may not meet all the coverage criteria. For that information, be sure to review the Indications and Limitations of Coverage section of the LCD. For example, the L4631 (CROW boot)

18

O&P ALMANAC MAY 2011

you have supporting documentation in your files. In the Diabetic Shoe LCD, however, the KX modifier indicates that coverage criteria have been met and that supporting documentation can be made available if requested.

Last, any other type of information that should be documented and submitted with the claim also will be found in this section, such as what information is needed when providing an item described by a miscellaneous code or a custom item.

The Policy Article, PA

Documentation requirements. This section informs you what type of information should be included on an order and when a new order is required. For example, the Lower Limb Prosthesis LCD states that if you are replacing a major component, a new order is required, and the KO LCD states that if you are providing a custom KO, your order must specifically state “custom fabricated” or list the brand name and model if available.

This section also tells you when and how the modifiers listed in the HCPCS Codes and Modifiers section should be used. Be aware, this may vary from policy to policy. For example in the KO LCD, the KX modifier indicates that coverage criteria have been met and that

Depending on how the medical policies are published, there may be a link to the corresponding PA, under the heading “Related Documents” or it will follow directly after the LCD. The PA expands on some of the information in the LCD and provides rules for when an item or service is considered not covered for reasons not related to medical necessity.

It also includes any other information about the benefit category the DME MACs wish to convey to you (for example, useful lifetime, repairs, or replacements).

A PA is divided into four sections, same as the LCD, and then further divided into detailed subsections.

Here, we will focus on the two subsections that hold the most information.

Nonmedical necessity coverage and payment rules. This section of the PA conveys information about items/services that will be denied as noncovered because they are not a Medicare benefit, are not reasonable or necessary, or do not meet other regulatory requirements. Unlike the LCD, items discussed in the PA will be denied as noncovered, which means that you will consider using the GY modifier.

This section also details the types of services that you may not bill for and when the DME MACs or Medicare are not responsible for processing or paying the claim. For example, if you’re wondering whether you can bill separately for using CAD-CAM in the fabrication of an LSO, when the hospital is responsible for payment of an LSO, or what prosthetic services the SNF is responsible for, review this section of the PA. Last, this section provides you with additional information on what must occur in order for you to receive reimbursement for covered services.

So, if you are trying to determine when and how repairs/replacements are covered, review this section.

Coding guidelines. This section gives an in-depth description of what each procedure code, listed in the LCD, actually entails. In essence, it is

telling you what Medicare is looking for when you bill for that particular code. For example, if you are trying to determine what exactly constitutes a CROW, L4631, a review of this section will tell you the six characteristics that must be present in the device in order to bill using the L4631. If the item/service you are providing doesn’t meet the description listed in the PA, you should reconsider what you are providing and try to find a more appropriate code. This section will also explain what exactly is billable when using the repair codes (L4205/L4210 and L7510/L7520).

Finally, both the LCD and the PA contain a revision history section. This section provides a detailed list of the changes to the LCD or PA and when these changes went into effect. Be sure to review this section every now and again to be sure you haven’t missed any changes. Keep in mind that it is possible for only one portion of the policy—the

LCD or PA—to change with no change in the other portion. This history will help you identify which LCD and PA was in effect on your date of service for a claim. If a claim was denied based on a recent policy revision, but the claim was submitted before the revision date, be sure to indicate this and provide a copy of the revision history in your appeal.

As you can see, the LCD and the PA each contain valuable information, but together they provide a wealth of information about what is covered (LCD) and what is not covered (PA), but also about payment rules, coding guidelines, and documentation requirements. You just need to know where to look. a Devon Bernard is AOPA’s manager of reimbursement services. Reach him at dbernard@AOPAnet.org.

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19

MARKETING STRATEGIES

for a New Business Climate

BY ANYA MARTIN

20

O&P ALMANAC MAY 2011

COVER STORY

Smart O&P practitioners are testing the waters of social networking but also nurturing some proven low-tech methods

W

hen Rochester ads. But you really should Hills, Michiganstep up your marketing based Wright when that kind of thing is & Filippis Inc., hired a happening.” market-research company Now Wright & Filippis six months ago to gauge is upping its advertising its brand penetration budget in the Detroit area, within its home state, including buying radio, TV, the results offered both and Internet ads—even Anthony J. Filippis, CPO good and bad news, says billboards, which are Anthony J. Filippis, CPO, president and less expensive than one might think CEO of the nation’s largest familyand have high penetration, Filippis owned supplier of orthotics/prosthetic says. “The majority of people go by services and home medical equipment. [a billboard] five times a week going The good news: Outside of to work,” he adds. “When you’re southeast Michigan, Wright & Filippis running it for several months, it’s a ranked as the number one choice for constant reminder.” name recognition in its market sectors.

Studies of the 1981-82 recession The bad news was that inside that key

by McGraw-Hill and others have region—which included its biggest found that companies that maintain market, greater Detroit—the company or even increase their advertising and was number two. marketing expenditures during recesBeing number two “wasn’t sions tend to have higher sales growth terrible,” Filippis says, but the study than firms that slash those budgets. served as a wake-up call because the At the same time, the rise of online 65-year-old company had cut back social networking is offering O&P significantly on marketing expenpractices new, cost-effective ways to ditures for that geographic area the reach potential referral sources and year before to save money during the patients. But practice leaders caution recession, which had hit Michigan against abandoning some tried-andespecially hard. true low-tech marketing strategies.

“It seemed like an easy place to cut,” Nurturing face-to-face relationships he says. “When challenging times continues to be the most effective way come around, you tend to look at to attract referrals and patients in this your low-hanging fruit. You cut those care-driven health specialty.

MAY 2011 O&P ALMANAC

21

COVER STORY

Brand Awareness

business cards, letterhead, ads, brochures, and his “If you want your signature line in emails. practice to be a market “I behaved like my leader, you should begin company was already 10 establishing your brand offices,” he adds. “That’s even before you open the biggest advice I’d give your doors,” says Jeffrey to anyone who founded a M. Brandt, CPO, founder practice tomorrow.” and COO of Gettysburg, Jeffrey M. Brandt, CPO The next step is transPennsylvania-based Ability ferring that logo into a brand, Brandt Prosthetics & Orthotics Inc., which says. “At Ability, our brand starts with has a strong reputation for providing top-notch practitioners delivering a quality, cutting-edge devices and consistently high level of care and customer service. Ability recently grew customer service,” he adds. “While from five offices in Pennsylvania and marketing to referral sources is crucial, Maryland to nine offices in four states, don’t forget that front-line customer after acquiring Lexington, Kentuckyservice delivery to patients means based BridgePoint Medical LLC, and they walk out and say positive things will open a 10th office this summer.

“I behaved like my company was already 10 offices. That’s the biggest advice I’d give to anyone who founded a practice tomorrow.”

— JEFFREY M. BRANDT, CPO

Top-talent O&P residents contact Ability because they’ve heard it’s a dynamic place to work. The company has been featured on national news programs, such as NBC Nightly News and The Today Show. And recently the American Board for Certification in Orthotics, Prosthetics & Pedorthics (ABC) announced it will photograph Ability’s locations for use in a national brochure highlighting quality O&P. “Having an appealing logo, using it consistently, and getting it out in front of key constituents as often as possible starts your practice on the road to creating a good brand reputation,” Brandt says. Seven and a half years ago, with just one office, he already had a logo and was putting it onto every document he generated, including

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O&P ALMANAC MAY 2011

philanthropic events that increase patient awareness. The company has hired a public relations firm to help organize these activities and market themselves.

Recently Ability enlisted a local amputee support group to help deconstruct artificial limbs to be donated to Physicians for Peace, a nonprofit group that provides training and supplies to health-care professionals in developing countries. The effort was covered by the local Fox News affiliate. The NBC Nightly News coverage came when Ability donated limbs to Haitian earthquake survivors, and the Today Show segment was on an Ability patient fitted with a cutting-edge prosthetic hand.

Ability also regularly asks patients for permission to take professional photos during fittings. The pictures are then available for use in brochures, on the company website (www. abilitypo.com), and in media outlets.

Documenting how well a device works strengthens relations with manufacturers, too, putting Ability at the top of their list for access to new technology and using the company’s experience to bring other practitioners on board with the product, further solidifying Ability’s reputation as a field leader.

“Marketing is like spinning this web; you have to make all these cross-connections you never thought you would,” Brandt says. “Be careful how you take that picture of a patient, device, or event because it may come back to you in a brochure, ad, or aid in recruiting a practitioner.”

to their referring physician, family members, friends, and more, and word of mouth can go a long way.”

Keep your waiting area clean and pleasant, and apologize to the patient if you’re running late, letting them know that you know their time is valuable, too, Brandt suggests.

High-Tech Marketing “We think of patients as By its very nature, health customers, while many care is a conservative field physicians and competwith many privacy concerns, itors don’t think that way,” so it’s no surprise that few he says. “You should O&P practitioners are active be appreciative that the on Facebook, Twitter, and patient is coming to your other social networking sites, practice.” says Jill Drawbridge, director Jill Drawbridge To ensure the good of marketing for San Diegoword gets out, Ability, like many based SCOPe Orthotics & Prosthetics practices, works with nonprofits Inc., which operates 13 offices in volunteering and participating in (Continued on page 25)

Patients of Austin-based Orthotic and Prosthetic Technologies Inc. participate in the company’s second sponsored First Volley Adaptive Tennis Clinic in October 2010.

Marketing and Giving Back: First Clinics

A

familiar one to Robin Burton, executive director of the nonprofit O&P Assistance Fund Inc. (OPAF), which developed a series of First Clinics for a variety of sports, including First Swim, First Dive, and McKeever’s First Ride (horseback riding). (OPAF also partners with the National Amputee Golf Association on its First Swing clinics.) Health-care providers pay $3,000 to OPAF, and OPAF organizes the event, provides instructors, and assists with publicity. While the philanthropic mission is foremost, many practices also find First Clinics a great public relations and marketing tool, generating press coverage and increasing company awareness among referral sources.

“The idea is that you invite an even wider population than your patients— anybody within your community—to participate in a free opportunity to learn how to swing a golf club again or to learn the benefits of swimming,” Burton says. “It makes the practice look like a good guy giving something back to the community.”

To spread the word, Orthotic and Prosthetic Technologies Inc., passed out flyers to rehabilitation Darren Kindred, OPAF’s First Volley Director of Tennis, instructs 25 of Orthotic and Prosthetic centers, physician’s offices,

Photos: OPAF & The First Clinics

ustin-based Orthotic and Prosthetic Technologies Inc. has established a subspecialty in working with adaptive athletes, and CEO Aaron Foreman, MSPT, CPO, and his family are avid tennis players. So when Foreman heard about the First Volley Adaptive Tennis Clinic, he immediately thought it would be a great fit for his practice, which has four offices in central Texas.

About 18 amputees and wheelchair athletes from around the Austin area attended the October 2009 event, which helps people learn or relearn a sport after an illness or injury. A local TV station did a story on the athletes’ experiences learning how to overcome their disabilities to play a sport they loved.

That story of satisfaction is a

Technologies Inc.’s patients.

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O&P ALMANAC MAY 2011

Executive director of OPAF, Robin Burton (right), Darren Kindred, OPAF’s First Volley Director of Tennis (left), and former Wimbledon-champion, Dennis Ralston, now a below-the-knee amputee, (center) watch participants during the First Volley Adaptive Tennis Clinic in 2010.

recreation centers, and tennis clubs.

Foreman was so pleased with the results that he decided to sponsor a second First Volley in October 2010.

This event attracted another 25 patients and featured ex-Wimbledon champion Dennis Ralston, now a below-the-knee amputee, whose participation drew even more media coverage.

“We’re trying to compete with big companies, so it gets the word out that we’re out there and that we’re on the cutting edge, working with athletes to get them back to sports,” Foreman says.

“It definitely is a great program. OPAF helps out with everything.”

To find out more about how your clinic can sponsor a First Clinic, visit www.opfund.org.

COVER STORY

Southern California. One reason is that the majority of O&P patients are seniors who aren’t active online, she adds.

Still, a smart, proactive practice needs to use all the marketing tools at its disposal to build its patient base, and younger family members, patients, and providers often are embracing new media, Drawbridge says. A first indication that times are gradually changing is that SCOPe dropped all its Yellow Pages advertising two years ago and saw no impact on patient rolls.

Like Wright & Filippis, SCOPe also prints fewer brochures. Now referral sources and patients can go straight to the company website and print a brochure on demand, which not only gives them access to instant, real-time information but also saves money and postage for the company.

The biggest strength of online marketing is the ability to post

“A proactive practice needs to use all the marketing tools at its disposal to build its patient base, and younger family members, patients, and providers often are embracing new media.”

— JILL DRAWBRIDGE

photos and videos that show quickly and efficiently how treatment by a SCOPe practitioner benefited a patient, Drawbridge says. At press time, SCOPe had only 173 followers on Facebook and seven on Twitter, but she sees both, in combination with YouTube, as a great way to disseminate images and footage

and boost name recognition and positive associations with SCOPe. “So much of what we do, especially in prosthetics, is visual,” Drawbridge says. “For example, we recently shot a video of a young man who lost his leg and ran for the first (Continued on page 27)

MAY 2011 O&P ALMANAC

25

Two O&P Nonprofits Tap Social Media While O&P practitioners have yet to integrate social networking into their marketing strategies to any great extent, two O&P nonprofits are providing provocative templates for how these online tools can drive specific goals.

Amputee Coalition Gets Star Power “Today I’m asking u to forgo something that costs u as lil as $5. coffee. a magazine. Instead give it to a young amputee http://bit.ly/hQMdLD.” That’s just one of many tweets Bianca Kajlich, star of CBS-TV’s Rules of Engagement, sent with the hashtag #BKAmpCAMP during the week of March 21 to raise $34,000 for child amputees to attend the Amputee Coalition’s Paddy Rossbach Youth Camps.

Kajlich became an advocate for amputees after her brother Andre lost both legs after being hit by a train in Prague, Czech Republic. The Twitter fundraiser was her idea to celebrate her birthday and leverage her fame to a good cause, inspired by pal and Bianca Kajlich fellow actress Eliza Dushku (Buffy the Vampire Slayer, Dollhouse), whose birthday Twitter campaign raised $30,000 to build a recovery center for former child soldiers in Uganda, says Jamey French, development director of the Amputee Coalition.

The nonprofit has had two active Twitter accounts (@AmputeesUSA and @ AMPUTEECAMP) for almost a year, garnering nearly 600 and 150 followers respectively by March, and has used Twitter for announcements, such as details about its annual conference and youth camps. But nothing Jamey French

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O&P ALMANAC MAY 2011

compares to the star power a famous advocate can provide, French says.

“The exciting thing is that Bianca has a number of famous friends like Eliza and David Spade who have said they will retweet her tweets this week,” French says.

“As a result, we’ll definitely raise money, but also an awful lot of awareness. We’ll have thousands of people who have never heard of the Amputee Coalition at least hear the name.”

To assist Kajlich, the Amputee Coalition provided her with key stats relating to amputation and quotes from children who enjoyed the camp, as well as setting up a dedicated website for her fund-raising where contributors can read a personal statement from Kajlich, watch a video, and gauge her progress on a thermometer.

And as an added incentive, Kajlich promised a personal thank-you phone call to anyone who gave $1,000 or more.

As for the final talley, Kajlich’s Twitter campaign raised $36,269.78 from 421 donors including several other celebrities. From an awareness perspective, it also generated more than 13,000 hits to the fundraising page, online articles, and blog posts, as well as a doubling retweets of the camp’s Twitter account followers from 70 to 156. With reposts by celebrity friends and fans, French estimates that as many as 2.5 million people saw tweets about the camp during the campaign.

Social Media as Customer Service Tool Board of Certification/Accreditation, International (BOC) doesn’t have a glamorous TV star to help raise its social networking coolness factor. But it does have a solid plan to leverage Twitter, Facebook, and LinkedIn to provide an additional fast and efficient customer-service tool for practitioners, says Jeffrey Price, MCP, operations director.

“Primarily we’re using social media to develop a presence and move toward being more accessible to our customers,” Jeffrey Price Price says. “We want to use it as another customer-service tool to increase our engagement [and], help foster a sense of community and connection to BOC and what we’re doing to assist them in maintaining their credentials or, if they’re new to the field, to get credentialed.”

Right now BOC is primarily posting announcements, such as policy changes, new rules, news releases, and media coverage, but Price envisions a time when practitioners will ask questions and get real-time responses—not just from BOC staff, but from colleagues in the field who happen to see the post and have insight to offer.

To encourage involvement and build its followers, which, in March, numbered around 100 on Facebook and Twitter respectively, the organization has added buttons to join its Facebook, Twitter, and LinkedIn accounts on its newly rebranded website (www.bocusa.org), as well on the signature block on staff emails.

Two final tips for practitioners: • Use a tool like Tweetdeck or HootSuite to organize your incoming tweets and cut through the noise.

• Consider putting your brand upfront when you share your Facebook URL by including your website’s full domain name (such as .com or .org). Instead of Facebook/bocusa, BOC set up bocusa.org/facebook.

COVER STORY time in the parking lot. The feeling you get watching this guy’s face—you can’t describe that to a doctor or another patient.”

The front page of SCOPe’s recently revamped website (www.scop.net) is topped with a photo and quote from a satisfied patient superimposed on a background of blue sky and clouds.

Scroll down to a short and specific mission statement and embedded video of a local TV news story featuring prosthetist Randy Mason, CP, demonstrating the I-Limb, a new high-tech prosthetic hand. The site also features links to product pages highlighting other cutting-edge devices available to SCOPe patients and links to blog posts about community service activities, including a SCOPe prosthetist’s account of his 2010 medical mission to Haiti. Click around, and each page header features the same blue-sky backdrop and the smiling face of a patient with another

one-sentence testimonial.

SCOPe also uses Facebook and Twitter to publicize company milestones, such as the launch of the new website in February, expansions of its Orange and Torrance, California, offices, and a recent local

news broadcast that featured the practice. It posted its booth location at the Amputee Coalition’s National Conference last summer, along with articles of interest to patients, practitioners, and referral sources, such as a news story about a soldier who lost his legs and is advocating for a bill in the Minnesota state legislature to help others who need prosthetics. And the company’s Facebook wall doesn’t just include copy loaded by SCOPe staff but also numerous testimonials and thank yous from grateful patients.

On the flip side, Drawbridge cautions, providers need to remember that whether or not you’re online, people may discuss your practice in an online forum, and those comments may not always be positive. That’s another reason to be active online, she adds, so that when people hit the search engines, the good news about your practice—the success stories—are out there, too.

MAY 2011 O&P ALMANAC

27

COVER STORY

Subtle But Effective

might have a need for us,” Frederick says. “Sometimes Scheck and Siress also we will find that some is testing the waters with practices do their own social networking and orthotics in-house, and then other online strategies, we look for an opportunity but Emily Frederick, to fill some kind of gap. director of marketing, For example, they may says the Chicago-based do off-the-shelf products practice’s most effective Emily Frederick but don’t do custom marketing strategy to [devices]. Sometimes we market recruit new patients remains in-service ourselves for their more complicated events and other face-to-face meetings cases.” with referral sources. Goals include A good goal is about two to three educating a new referral source in-service events per location each about your practice’s strengths and month, but the company may conduct the breadth of the services you offer, more or fewer depending on whether solidifying an already-established one of its practices has a full patient relationship, or introducing new staff load or has had a decrease in patient members or services, she adds. referrals, Frederick says. Lunch hour is “The in-service doesn’t sell us,”

“Sometimes we will find that some practices do their own orthotics in-house, and then we look for an opportunity to fill some kind of gap.”

—EMILY FREDERICK

Frederick says. “It’s the relationship that really brings patients in the door and why a group will call us above calling another practice.”

Frederick works with lab managers at Scheck and Siress’s 12 metroChicago offices to identify physician practices, hospitals, rehabilitation providers, physical therapists, and other nearby potential referral sources whose patients might need O&P services. She then cross-references the provider with the patient database to see how many, if any, recent referrals have come from that provider. In the case of a hospital that hasn’t been making referrals, she’ll look up specific doctors who might be a good fit.

“We target the doctors or entities that

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O&P ALMANAC MAY 2011

an ideal time for these events, as most offices take some kind of structured lunch break. Like many pharmaceutical reps, Scheck and Siress always goes to the target practice and brings a simple lunch, such as sandwiches, for the doctor and key staff members.

She recommends not bringing too many people from your practice.

A typical in-service might include Frederick herself or another marketing person, the lab manager for the closest office, and perhaps another specialist with particular relevance to the targeted provider, such as a pain management specialist for a neurologist’s office.

“It’s important to have the right people and not too many people,”

Frederick says. “You don’t want to overwhelm the meeting. You don’t want to walk in with five people and there are only four people from the office you’re visiting.”

Finally, she adds, while it’s important to have a list of information you want to deliver and obtain at an in-service session, don’t get stressed out if much of the conversation remains casual or if it seems devoted to one patient or the nuances of one device. Remember, the key when it comes to a successful in-service is laying the groundwork to build a relationship, Frederick stresses, rather than jamming as much information as possible into the encounter.

None of this negates the importance of a patient seeing the name of your practice on Facebook, on the news or in an ad, she says. At the end of the day, as many marketing experts attest, brand recognition is not about the first encounter but the third, the fourth, even the fifth.

“Then, if the doctor gives [the patient] a list of three places to go,” Frederick says, “they’ve heard of us before so they’re more likely to choose us.” a Anya Martin is a contributing writer to O&P Almanac. Reach her at anya99@ mindspring.com.

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O&P ALMANAC MAY 2011

BY

JILL CULORA

e m e r t x E OVER

E K A M O&P EDITION

SPURRED BY POLICY AND MARKET CHANGES, SAVVY O&P PRACTITIONERS ARE REMAKING THE PROFESSION TO STAY AHEAD OF THE CURVE

F

ew forces stimulate creativity more than change and competition, and today’s O&P professionals are in the midst of an extreme makeover.

Reimbursements are down, insurance approvals are increasingly complex, and the once exclusive O&P space is now overcrowded with nontraditional players.

So, armed with a vision of what the future holds, O&P practitioners are remaking their businesses—and the profession—in order to remain successful amid a rapidly changing landscape.

“It’s all creative. There’s no cookie cutter A + B + C + D = profitability,” says Eileen Levis, CEO and president of Orthologix in Philadelphia.

Facility makeovers can come in all shapes and sizes, but they typically include retooling the way you practice, expanding the products you offer, and growing your physical space. Makeovers can focus on any one of these areas or combine two or all three.

Go Beyond the Device Gone are the days of simply filling prescriptions and getting paid. The emerging O&P business model is about patient care, addressing reimbursement constraints, and staying ahead of the competition.

“Outcomes-based [treatment] is paramount in the field right now, and everyone is talking about it,” says John Held, CO, president of Great Steps Orthotic and Prosthetic Solutions in Plymouth, Minnesota.

“As things get more expensive, the insurance companies aren’t giving blanket approval of what we do, so we almost have to prove why we are doing things versus being allowed to do it,” he says. “Down the road, we foresee that it will be outcomes-based, so you’re going to need to prove that what you have done has worked in order to get paid. And a lot of that will be an assessment of how a person has changed and if they’ve met the goals that you’ve set for them.”

MAY 2011 O&P ALMANAC

31

It also makes good business sense for the O&P community to capitalize on its strengths of ­­ knowledge and education when competing with nontraditional sources such as manufacturers, pharmacists, doctor’s offices, and the Internet.

and communicate what we are doing with everybody, that’s our true value because we will have better outcomes,” Burns says. “We have more training.

We have accredited schooling. We’ve done residency programs. We’ve

“Our competitive advantage is not a specific product or a type of product.

It’s our care model we provide.”

—ERIC BURNS, CO “Our competitive advantage is not a specific product or a type of product.

It’s our care model we provide,” says Eric Burns, CO, area practice manager with Hanger Orthotics and Prosthetics in Tucson, Arizona.

“If we educate and evaluate patients,

committed a lot more to the education process than anyone else, so our knowledge in the care and utilization of prosthetic and orthotic devices far exceeds anybody else’s.”

Burns says that in the past, an evaluation for an ankle-foot orthosis prescription would stop at AFO rather than evaluate the entire patient to see what else might be going on. But a limited approach is no longer enough.

“We have all these tools that can help somebody—are we utilizing all these tools for every patient?” he asks. “It means becoming a solutions provider—that may require referring somewhere else, but ultimately giving our patients more options because we understand those patients better than anybody.”

Education is the key to becoming a “solutions provider”—educating your patients and educating your referral sources about what you provide.

“If you do an evaluation and write recommendations back to the referral,

you are broadening your scope and defining who you are instead of letting someone else define what your role is going to be,” says Burns. And, he adds, it prevents a narrowing of the scope of your practice.

Of course, your recommendation has to be sound: “If you make bad recommendations, you’re done,” he says. “The evaluations should build trust in the relationship between the O&P provider and the patient and the referral. So for this to work, you have to be a good practitioner.”

Change How You Work Options for adding products to your practice seem endless—from adding physical therapy services to offering functional electrical stimulation devices or incorporating a mobile lab.

(See page 36.) And today’s O&P practitioners are successfully combining the many options.

For example, when John Held contemplated a recent expansion at Great Steps Orthotic and Prosthetic Solutions, he foresaw growth in the pedorthics field and decided to make space for a shoe exam and shoe stock area.

“There’s going to be a bigger need, and instead of having our certified orthotist doing as much of the foot and diabetic work, we decided to increase our staff with a certified pedorthist,” says Held, whose recent facility makeover also included adding a gym, a library, a second lab exclusively for clinicians, and extra exam rooms, as well as updated electronic medical record software and new work-flow patterns.

MAExt r O&KE em PE O e DI V TI ON E R

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O&P ALMANAC MAY 2011

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Extreme

MAKEOVER O&P EDITION

O&P

BUSINESS BENEFITS

POTENTIAL REVENUE

COSTS TO IMPLEMENT

Out-of-the-Box Add-Ons

FUNCTIONAL ELECTRICAL STIMULATION

SURGERY CENTER ORTHOPEDIC PRODUCTS

PHYSICAL THERAPY

MOBILE LAB

WOUND CARE

Offers patients alternatives to AFOs, targets new patient populations, strengthens relationships with physical therapists and physicians, and builds new relationships with neurologically impaired patients and their providers.

Strengthens relationships with referral sources, expands patient base.

Easy way to expand into a new territory while strengthening relationships with referral sources.

Strengthens relationships with patients and care team, expands your reach without the cost of a second office, treats homebound patients, saves clinician time and allows quicker start of PT or discharge.

Provides assistance and advice on wound care to existing patients and increases client base through expanded referral sources.

$300,000 to $350,000 per year.

$400,000 to $450,000 per year.

$150,000 to $200,000 per year.

$450,000 per year.

Medicare reimbursement for Negative Pressure Wound Therapy is $1,700 per patient per month.

Initial investment $10,000 1 orthotic fitter (approx. plus ½ time for 1 orthotist. $40,000) to manage and control consigned inventory in existing inpatient O&P facility.

$100,000 to $110,000, including supplies.

$53,000 for a fully equipped Initial cost to purchase mobile lab, incorporated into units, $14,000; staff an existing O&P practice. training is additional.

SPACE

Minimal additional space required.

WORKS BEST FOR

Patients with upper motor Serves all demographics neuron lesion, in collabowhile adding on-site proviration with PT in outpatient sions and service. setting.

2,000-3,000 sq. ft. for O&P Requires a fairly large practice in institution. physical space.

Post-rehab clientele, including clients with cerebrovascular accidents (CVA), other neurological disorders and amputees.

No additional space required.

Small amount of space required for units.

When used in conjunction with a physical therapy clinic where multiple patients are seen on a single visit.

Patients with diabetes, lower extremity wounds, or vascular and arterial diseases.

Source: Jim Kaiser, CP

The Great Steps makeover made space for a much larger walking area so practitioners could do more in-depth analysis for amputees and orthosis. The space includes two long parallel bars, measuring 40 feet, plus shorter bars, handrails, ramps, and exercise mats.

Exam rooms and a resource library open directly into the gym.

Held says making so many changes at once was a challenge, but one that he worked through with clear communication with staff. “We did lots of training, lots of meetings, doing real life situations—just open

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communication,” he says. “It requires a concerted effort for everyone to sit down, individual departments to work on their parts, and then meet together to see how it’s interacting with everything else.”

His staff understood the clear goals: to meet the standards of tomorrow and work as efficiently as possible.

“Everybody understood where it was going. It still took people out of their comfort zone,” Held says, “but a least they knew they had time to get there.”

In a different kind of makeover, Jason Henry, MSPT, LO, practice

manager at Hope Orthotics in Spring, Texas, added a mobile lab to his practice three years ago because he was already spending a lot of his time working away from his office. “I specialize in pediatrics, and I only do orthotics,” says Henry. “The location where I treat these children is different from adults. I do a lot of hospital calls, and I don’t have walk-ins at my office.”

Henry says his goal with the mobile lab “was to try to provide a better service, to get better outcomes for the children in regard to collaboration between clinicians.” The makeover

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ORTHOPEDIC FOOT, ANKLE & KNEE INSTITUTE

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atients and practitioners alike benefit from the soup-to-nuts approach to patient care at Orthopedic Foot, Ankle & Knee Institute. After seeing owner Barry Ruht, MD, for a diagnosis and treatment plan, patients who require orthotic services can immediately consult with staff member Lori Boyle, CO, for an orthotic evaluation.

Ruht believes that having the physician and orthotist in one location not only saves time, it also improves communication between specialists and results in better care. Boyle agrees.

“Normally, an O&P practice is in its own facility, so communication with the doctor can be delayed,” says Boyle. “This is so much smoother than calling doctors, waiting for them to call back, and hoping they don’t forget to do so. I never have to hunt down the doctor to clarify something, because we’re all right here.”

Boyle had worked in small, family-owned O&P facilities and a larger company before joining Ruht’s practice five years ago.

“Each one has its own personality,” she says, “but this one works best for me. I prefer having the doctor right on site; it’s amazing how much guesswork is taken out of the process. I can read his notes, talk to him, see the X-rays, and see what the long-term plan is. Our jobs complement each other in one unique care setting.”

Treatment and Technology Ruht established Orthopedic Foot, Ankle & Knee Institute in 2005 after 21 years of working with a group of other board certified surgeons in the Lehigh Valley area of Pennsylvania. He did a fellowship year in foot and ankle orthopedic surgery at the University of Pennsylvania and then returned to the Valley to open his solo practice.

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O&P ALMANAC MAY 2011

The facility has two offices, one of which focuses on physical therapy; there are 12 employees, including seven clinicians. Ruht sees a variety of patients, including adults, teens, and competitive athletes. About 44 percent of his patients are on Medicare.

Although Ruht treats a wide range of orthopedic issues, between 60 and 70 percent of his cases involve foot or ankle problems.

“I treat everything conservatively and nonsurgically first,” he says. “A high percentage of my patients get some sort of orthosis, and most never require surgical reconstruction because of the success of the orthotics treatment.”

Ruht takes pride in adopting new technology for his practice. For example, Orthopedic Foot, Ankle & Knee Institute has been using electronic medical record keeping since 2006.

One area of technology, though, proved less than satisfactory. After using CAD-CAM (computer-aided design and manufacturing) for fabricating orthoses, Ruht was unhappy with the process and returned to hand casting and fitting. Boyle fabricates and modifies many devices herself, as well as using central fabrication.

Central to Ruht’s philosophy of care is providing prompt attention. Most patients are able to make appointments within 48 hours, and, thanks to Boyle’s presence on site, receive comprehensive care without leaving the building.

“Getting patients in and out in a timely fashion is important to us,” he says. “Every patient is a new test, and we take that seriously.”

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Whether it’s building an addition to your current space, opening a second location, or acquiring a practice from a competitor, growing your physical space can bring in more patients and more revenue.

But it also entails many more considerations than most people realize, say those with experience in expanding their O&P facilities.

growth opportunities, factoring in current patients and referral bases in that area, and determining whether you will need to hire new staff. Types of office space and timetable are the next considerations, along with evaluating how your expansion will affect your existing revenue and operations.

O&P facility owners who expand their facilities should expect increased costs in almost all areas of operations.

“You may look and say, ‘Wow, rent is really cheap in that area, and I think that’s where I’m going to expand my practice,’ but if you’re primarily into sports medicine and the space is

“The only time people should expand is when there is untouched opportunities that will benefit their business,” says Levis of Orthologix.

“It may be a niche that they want to capture or a location not being serviced by one of their competitors, or they foresee an increase in demand for their services.”

Expansion is expensive and stressful, and it comes with a seemingly endless list of considerations, says John Schulte, CPO, FAAOP, a clinical educator with Fillauer, who delivered a presentation titled “To Expand or Not To Expand” at AOPA’s 2010 National Assembly.

“Expanding can be a great thing for a business owner to do because it can be so rewarding,” says Schulte, “but you have to look at all the aspects of the expansion before you pull the trigger.”

Among the considerations Schulte lists are reviewing populations and demographics, looking at future

surrounded by retirement communities, then you’re not going to have the volume or the interest of the type of patient you’ll want to have,” he points out.

Schulte encourages people to think outside the box when expanding space and products. Sharing space with a referral source, for example, has both benefits and drawbacks.

Splitting the costs of running an office and being convenient for patients has an appeal, but be sure each party is paying fair market value for the space to avoid being viewed as accepting kickbacks. Sharing office space can also mislead other referral sources into thinking you have an exclusive arrangement with that source.

“And if you’re new in that area, the last thing that you want is to open yourself up to being under scrutiny and have that out into the field,” he says.

Expansion, obviously, has its pros and cons. The upsides include:

also made sense from a practical standpoint, he says: “It’s more convenient for the parents because it’s one less trip they have to make.”

Grow into New Space

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O&P ALMANAC MAY 2011

• increased revenue • increased presence within the target community • increased staff, resulting in freeing you to focus on the types of patients you have a special interest in • ability to service a greater number of referrals more efficiently, thereby better serving the referral sources and, as a result, growing your business even more.

On the other hand, expansion has its downsides as well: • more time spent away from the primary office while growing the new location, resulting in decreased patient care time in existing locations • loss of revenue base in existing locations • increased management headaches due to more staff and daily operational issues • increased technology needs, which often require expensive upgrades and equipment • increased related costs for all types of insurance, including liability and property • increased daily costs for automobile, office supplies, and telephone.

“A lot of people make the mistake of opening a second location to accommodate their existing customer base when they’re really splitting their customer base in half, and of course that location will not be a profitable one, but it will be a convenient one,” says Levis.

Still, she cautions against ignoring the need for change at O&P facilities today, saying business owners are at risk of “extinction.”

“Even if you’re not a real smart business person, you do see what is going on in the industry to some degree, and you know whether you are resisting change or resisting the different flags and indicators that are coming up,” she says. “You know that you are going further and further away from being a successful practice.” a Jill Culora is a contributing writer to O&P Almanac. Reach her at jillculora@gmail.com.

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AOPA Headlines AOPA WORKING FOR YOU

Strengthening the Profession AOPA’s Policy Forum Makes the Case for O&P

T

he O&P community reached a new level of Congressional visibility with the 2011 AOPA Policy Forum. More than 100 O&P professionals gathered in Washington’s L’Enfant Plaza Hotel on April 11 for briefing sessions and educational meetings about the issues affecting the O&P community and how to present the case for O&P to their Congressional representatives.

The next day, AOPA members held a record 413 meetings with members of Congress. And, a special bonus— somewhat attributable to the uncertainty of a government shutdown—many of the Senators and members of Congress AOPA Executive Director Tom Fise moderates a discussion between former congressmen Earl Pomeroy of Nevada and Scott Klug of Wisconsin. appeared at these meetings. (Usually meetings are held with Congressional staff because of representatives’ busy schedules.) reimbursement is limited to only those credentialed by Representative Wally Herger (R-California), chairman of a recognized body that meets ABC or BOC standards. the powerful House Ways and Means’ health subcommittee, • It limits deemed accrediting bodies to those experienced headlined the list of presenters. Rep. Herger concluded in O&P that meet Benefits Improvement and Protection the program with a hard-hitting message on reigning in Act’s 427 criteria. government spending, but made a special point of singling • It links reimbursement to the qualifications of the provider out the great contribution from the O&P community. The and the complexity of the device the patient needs.

O&P Political Action Committee hosted a reception for Congressman Herger later than evening.

Insurance Fairness for Amputees Act (S.773). Providing In addition, Laurence Wilson, director of the Chronic Care timely O&P treatment can avoid costly co-morbidities and Policy Group for the Centers for Medicare and Medicaid, return patients to active, productive lives as taxpayers instead outlined the agency’s approach to implementing the new of consumers of tax dollars. This legislation was previously Affordable Care Act and made clear the pressures involved in known as “O&P Parity,” but many misunderstood this as a trying to keep Medicare and Medicaid solvent. mandate for coverage. The bill was renamed to clarify that if a Most critical, however, were the sessions geared toward private insurer chooses to offer O&P coverage, it must provide shaping the messages on important issues AOPA members it with the same surgical and medical benefits associated with would be advocating during their Congressional meetings. other covered risks with no caps or lifetime limits.

Here’s a synopsis of the seven issues targeted for this year’s agenda.

Orthotics and Prosthetics Included in Definition of “Essential Benefits.” It was always intended that O&P be O&P Medicare Improvement Act. This saves taxpayers included and was clearly stated in the House version of a minimum of $250 million over five years by curbing fraud the Affordable Care Act. However, the Senate version was and abuse. Key components: signed into law and left defining essential benefits to the • In licensure states, reimbursements only given to Secretary of Health and Human Services. Rep. George Miller those properly licensed. In non-licensure states, 40

O&P ALMANAC MAY 2011

Past President of AOPA James Kaiser, CP, Amputee Coalition President and CEO Kendra Calhoun, and Rep. Wally Herger (D-CA).

John Kenney, former vice-chair of the BOC board of directors, presenting a special gift to the AOPA Promote Committee on behalf of BOC and its president and CEO, Claudia Zacharias.

Catriona Macdonald, AOPA lobbyist with Linchpin, speaking about strategies to increase funding for O&P education and outcomes research.

Frank Bostock, CO, FAAOP, and Melinda Lisle, speaking about their experiences combating state Medicaid cuts.

AOPA President Tom DiBello, CO, FAAOP, speaking with Rep. Herger.

Peter Thomas, counsel for the O&P Alliance and general counsel for NAAOP discussing PPACA.

(D-California, Seventh District) and Rep. Bill Pascrell, Jr., (D-New Jersey, Eighth District) have issued statements in the Congressional Record confirming this intent. Not being included could seriously affect O&P patient care with thirdparty payers all over the lot in providing coverage.

O&P Medical Devices Excluded from 2.3 Percent Excise Tax. O&P providers deliver a finished device at their facilities to patients for their individual use, and therefore should qualify for one of the exemptions from the tax set out in the law. The Food and Drug Administration’s rulings over the past 35 years have referred to retail O&P patient-care facilities. Eyeglasses and hearing aids are exempt as prescribed custom articles, which in many ways match the process of O&P provided care. AOPA believes both manufacturers and patient-care facilities qualify for the exemption.

Veterans Bill of Rights (HR 805) Support. Veterans need to know their current right to obtain treatment from a practitioner of their choice in a venue of their choice. The bill requires these rights to be posted in every VA O&P clinic for injured and amputee veterans to see. It promotes a continuum of care for amputees transitioning from the Department of Defense to the Department of Veterans Affairs.

Short Term Grants Needed to Train Future Practitioners. The aging population and increasing incidence of diabetes and other cardiovascular diseases creates growing demand for highly skilled practitioners to provide O&P services. These grants are needed to meet this critical demand.

Funding Needed for Outcomes-Based Research/ Evidence-Based Practice. While Congress has provided research funds to restore maximum functionality for wounded warriors and veterans, O&P research has been less focused on outcomes than has research by allied health professions. Key questions remain unanswered, but outcomes research can be vitally important in reducing future health-care costs and ensuring that patients receive appropriate, necessary care.

To access detailed position papers, expanded talking points, and scores of photographs of the two-day event, visit www.AOPAnet.org and click on the 2011 Policy Forum button. More importantly, make a commitment to attend next year’s AOPA Policy Forum. It’s truly a not-to-be missed event for the future of your patients and you! a

MAY 2011 O&P ALMANAC

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AOPA Headlines

Preventing Claim Audit Disasters Having your claims audited can be a stressful and intimidating experience. Small errors or omissions can cost even the most compliant providers valuable assets due to refund requests and further audits.

The June 8 AOPAversity Mastering Medicare Audio Conference, “Preventing Audit Disasters,” will help you understand how to minimize the impact of claim audits on your organization. Discussion topics include: ½½ proper documentation techniques ½½ responses to an audit request ½½ techniques to minimize potential exposure during an audit ½½ tips for correcting errors discovered during an audit ½½ development of internal audit techniques.

The cost of participating is always just $99 per line for AOPA members ($199 for nonmenbers) and any number of employees may listen on a given line. Listeners can earn 1.5 continuing education credits by returning the provided quiz within 30 days and scoring at least 80 percent.

Contact Devon Bernard at dbernard@AOPAnet.org or 571/431-0854 with content questions.

Register online at https://aopa.wufuu.com/forms/2011telephone-audio-conferences/. Contact Ann Davis at adavis@ AOPAnet.org or 571/431-0876 with registration questions.

O&P Almanac COMING NEXT ISSUE

2011 BUYER’S GUIDE Watch your mail for the June 2011 issue!

For more information about the O&P Almanac and other AOPA publications, visit us online at www.AOPAnet.org.

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O&P ALMANAC MAY 2011

AOPA Advanced Coding and Billing Seminars 2011 Dates Announced The American Society of Professional Coders named AOPA’s Advanced Coding and Billing Seminar an approved program; and our first seminar of 2011 is coming soon. Don’t miss the opportunity to listen to two days of valuable O&P coding and billing information from AOPA experts. The Advanced Coding and Billing Seminars include breakout sessions for practitioners and administrators that will focus on each group’s specific interests and educational needs.

The first AOPA Advanced Coding and Billing Seminar of 2011 is at The Mirage Resort and Casino in Las Vegas on May 19-20, 2011. AOPA has secured a room rate at The Mirage of $125 per night.

AOPA will host a second seminar in San Antonio from June 15-16 at the Marriott River Center (room rate of $159 per night) and the third and final seminar of 2011 in Baltimore, on October 24-25 at the Sheraton Inner Harbor (room rate of $159 per night).

You will learn: • medical policies to improve your reimbursement • tips for documenting your interaction with patients • successful compliance plan best practices • strategies for performing self-audits of charts and resolving problems.

Practitioners will cover: • general coding principles • “hands-on” coding of specific devices • proper coding for repairs and adjustments • reimbursement for unlisted codes • mutually exclusive codes that should not be billed together.

Administrators will cover: • updated Quality and Supplier Standards • strategies for handling appeals and denials • strategies for handling unique billing situations • documentation requirements • Medicare as secondary payer.

Check out our website for more details and online registration links. Questions? Contact Ann Davis at adavis@AOPAnet.org or 571/431-0876.

n

AOPA Headlines

AOPA to Host First World Congress in U.S. AOPA is pleased to announce that it will host the 2013 World Congress of O&P. During meetings with various international groups at the 2008 Reha-Teknik show in Leipzig, Germany, AOPA explored its desire to host a World Congress of O&P in 2013. The response was so encouraging that we have proceeded to firm up plans for this globally significant event—the first U.S.-hosted world congress for the

orthotic, prosthetic, and pedorthic rehabilitation profession.

AOPA extends a personal invitation to you and your professional organization to participate in this event as a partner, exhibitor, and/or presenter. Please mark your calendar for September 18-21, 2013, at the Gaylord Palm Resort in Orlando.

AOPA Argues Against Medical Device Excise Tax Federal and state governments are in the midst of budget and debt-ceiling battles. Many states have to close budget deficits and may have to make state Medicaid program cuts. Meanwhile, battles over implementing health-care reform legislation continue—with a Democratic president-appointed judge, part of the 5th U.S. District Court, ruling the new law constitutional.

With much of our future, our patients’ futures, and the viability of the industry as a whole at stake, AOPA is working at full capacity to advance your interests and your patients’ needs.

The IRS and the Department of Treasury are deciding how to collect the new 2.3 percent medical device excise tax. In mid-February, AOPA representatives met with IRS and Treasury officials to explain O&P, its patients and products, and to argue that we fall within one of the key

44

O&P ALMANAC MAY 2011

exemptions from this tax.

This tax poses a potential threat to both manufacturers and patient-care facilities. We answered an invitation from the IRS and Treasury and wrote to both organizations arguing against applicability of this tax to O&P manufacturers and/or patient-care facilities.

Read AOPA’s comments submitted to the IRS regarding the 2.3 percent medical device tax at http:// www.aopanet.org/2011_IRS_Device_ Comments.pdf There is no sign that legislative activities are going to let up. You can expect to hear from us soon regarding legislative activity that could affect your business, and what actions AOPA is taking to assure the best outcome for O&P. Questions? Contact Steven Rybicki at srybicki@AOPAnet.org or 571/431-0835.

O&P PAC News The O&P PAC would like to acknowledge and thank the following AOPA members for their recent contributions and support *: • Mike Allen, CPO, FAAOP • George Breece • Tom Rankin • Jeffrey Yakovich, CO. The PAC also recently made a donation* to Rep. Glenn Thompson (R-Pennsylvania, Fifth District), co-chairman of the Congressional Healthcare Caucus.

Rep. Thompson The O&P PAC advocates for legislative or political interests at the federal level that affect the orthotic and prosthetic community.

Committee members work closely with members of the House and Senate to educate them about O&P issues, and to help elect individuals who support the orthotic and prosthetic community to achieve this goal.

To participate in the O&P PAC, federal law mandates that you must sign an authorization form. To obtain an authorization form contact Devon Bernard at dbernard@AOPAnet.org. *Due to publishing deadlines this list was created on March 17, 2011. Any donations received or made after March 17, 2011, will be published in the next issue of O&P Almanac. a

We were with Beth.

Every step of her way.

JUST LIKE YOU Beth Davis, CMF co-owns Just Like You, one of the many BOCaccredited facilities making a difference to their patients every day.

Background: Beth and her mother opened Just Like You in 1997. Beth worked there part-time until graduating from Louisiana Tech.

Impact: With Susan G. Komen Breast Cancer Foundation support, Beth co-founded a program to provide no-cost care to uninsured or underinsured breast cancer survivors.

Service: Beth’s commitment to service doesn’t end at Just Like You. She has been selected to serve on major manufacturers’ retail advisory panels, where she shares her industry knowledge.

“

I cannot imagine navigating this field without BOC. I count on BOC to make sure that we are not only in compliance with all regulations, but that we have the training and support to achieve our goals.

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Marketplace

ORTHOTIC MANAGEMENT OF GENU-RECURVATUM COMBINED WITH FOOTDROP Allard USA introduces COMBO, a thigh cuff/knee brace attachment for ToeOFF or BlueRocker that offers lightweight, low-profile, functional orthotic solution for the management of genu recurvatum or chronic knee instability, accompanied with footdrop. Combine COMBO with ToeOFF or BlueRocker to fabricate a KAFO, customized to meet your patient’s needs. Uprights with dual axis joints are easily shaped and adjusted to optimum height for the patient. Adjustable knee control popliteal interface for genu-recuvatum control. Modular components allow you to accommodate variances in thigh and calf circumferences.

For more information call 888/6786548, email info@allardusa.com or visit www.allardusa.com.

MT. EMEY MEDICAL COLLECTION SHOES This category of shoes is designed for hard-to-fit feet with larger orthotics needs. It offers a variety of closure for easeof-fit adjustability.

These shoes will accommodate mild or severe foot deformities, such as edema, charcot, bunion, and RA, and are in stock for on-time delivery.

Whether you need to order the custom orthotics only or from a wide selection of Apis shoes, we offer great package deals.

For more details, call our friendly CSRs at 888/937-2747.

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O&P ALMANAC MAY 2011

COLLEGE PARK INTRODUCES THE VELOCITY™ FOOT

EURO INTERNATIONAL PRESENTS THE NEURODYN

College Park Industries (CPI) is pleased to introduce their newest prosthetic foot, the Velocity. This innovative foot complements CPI’s line of low maintenance, multi-spring feet, including the highly successful Soleus®. The Velocity delivers a lower profile along with coupled toe springs that work together to provide a progressively smooth roll-over. The design also includes a responsive composite heel for dynamic function. CPI’s signature gait matching process and same day custom build allow each Velocity spring to be ergonomically tuned, providing an appropriate amount of dynamic response. The foot provides high functionality and low maintenance, with easy heel adjustments for fine-tuning. The versatile Velocity has smooth, controlled action and is appropriate for middle-to-high impact level users.

College Park Industries has been a lower-limb prosthetics industry leader for more than 20 years. CPI designs and manufactures high-quality, anatomically correct foot/ankle systems with a superior range of motion as well as the iPecs, a wireless prosthetic gait lab. Emulating human anatomy and highly customizable, CPI products enrich the lives of tens of thousands of satisfied users throughout the world.

With state-of-the-art design and precise engineering, College Park remains committed to the research and development of the finest prosthetic products.

For more information, call 800/7287950 or visit www.college-park.com.

Euro International presents the Neurodyn, a new and innovative foot orthosis which amongst other qualities supports the dorsiflexion and improves pushoff in CNS-related dorsiflexion pareses. The Neurodyn assists the recovery of lost muscular functions, helps lift the foot during gait, and increases the step range through obtained muscular dynamics thus creating an overall better physiological gait pattern. This orthosis also stabilizes the ankle joint, and as a result, decreases the danger of twisting the ankle. The Neurodyn also improves the proprioceptive effective and passive correction of the supination and plantarflexion. As indications peroneal weakness and all degrees of flaccid foot lifting issues can be listed. The Neurodyn features an easy-to-put-on Velcro closure, a one-hand system using a finger loop.

The figure-eight-style elastic restraint is numbered ensuring correct application of the Latex-free product which comes in various sizes and colors.

For more information, call 800/3782480 or visit www.eurointl.com.

NEW WAVE SPORT FOOT SYSTEM BY EMOTIS The all new Wave Sport Foot is the most versatile foot available that can handle anything from light jogging to the most punishing sports.

The Wave Foot can be worn with our flexible foot shell so the user can wear standard athletic shoes.

• Unique Wave-Spring Technology • “C” pylon has superior dynamic response • Accommodates a wide range of activity levels • Two clearance levels are available; 7.5 in and 9.5 in • Integrated heel design provides superior stability • Durable; meets the ISO-22675 test standard • Rated to 275 lbs.

Distributed worldwide by Fillauer LLC 800/251-6398 or www.fillauer.com.

OPTEC USA SPECIAL APRIL 1 THRU MAY 31: 20% OFF STOCK MODULAR BRACES LSO AND TLSO Optec USA’s Stock modular braces are designed to restrict unwanted movement and control the spine in single or multiple planes of motion.

Prefabricated stock sizes can be

trimmed, molded, or modified to provide your patients with an intimate custom fit. OPTEC USA’s rigid spinal system provides superior stabilization and support that your patients need with the ultimate comfort they deserve.

SALO not included in sale. These promotions apply to standard pricing and cannot be combined with any other discounts or promotions.

Find out more about these and other products: Call us at 888/982-8181 or visit us at www.optecusa.com.

INTRODUCING KISS SUPERSLIDER™ The Superslider™ simplifies test socket dynamic alignment. It allows linear alignment changes in the transverse plane and slides 1 in in all directions. It is durable and reusable. Combine with KISS Superhero™ damage-free test socket plate, with pyramid or receiver, and achieve superior test socket slide and angular adjustment.

• KISS Superslider™ Part#: CMP28/A • KISS Superslider™ KIT (includes KISS Superhero™) Part#: CMP29/A Contact KISS Technologies at 410/663-KISS (5477) or visit www.kiss-suspension.com.

Provel offers cost effective, fast, easy to use, and reliable O&P automation. The D2 digitizer, C7 carver, and T7 thermoformer are appropriate for small clinics as well as large central fab's.

AOP file compatible and backed by a two year warranty. The D2 digitizer allows automated shape capture of prosthetic casts with unmatched accuracy. The C7 carver is not only fast and precise, its self contained dust collection system is extremely quiet. The T7 thermoformer consistently produces high quality thermoplastic sockets from industry standard preforms.

For more information visit www.provel.us or call 509.857.2009.

MAY 2011 O&P ALMANAC

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Marketplace

OPTEC USA SPECIAL APRIL 1 THROUGH MAY 31: $59 OASIS REHAB™ LSO The bivalve Oasis Rehab with rigid anterior and posterior polymer panels provides compression and stabilization from L1 to L5 vertebrae. The Rehab anterior is available in neutral or pendulous abdomen; the posterior is available in three different degrees of lordosis resulting in an intimate fit that provides support, comfort, control, and increased patient compliance.

These promotions apply to standard pricing and cannot be combined with any other discounts or promotions.

Find out more about these and other products: Call us at 888/982-8181 or visit us at www.optecusa.com.

THE NEW PROPRIO FOOT® WITH EVO™ BY ÖSSUR. STABLE, SMOOTH, AND COMFORTABLE The newly redesigned PROPRIO FOOT with EVO utilizes intelligent ankle flexion to help users walk confidently and naturally without watching the ground, so they don’t need to think about every step for fear of tripping and falling. The lifelike ankle movement enables the PROPRIO FOOT to adjust for normal sitting and standing, and features automatic alignment for adapting to various types of footwear. PROPRIO FOOT recently received the prestigious Red Dot International Design Award over more than 4,000 submissions from 60 48

O&P ALMANAC MAY 2011

nations. Suggested Medicare assigned billing code is L-5973.

For more information, please call 800/233-6263 or visit www.ossur.com.

NEW! RE-DESIGNED E-MAG ACTIVE KAFO: TAKE A STEP IN THE RIGHT DIRECTION! New feature allows patients to temporarily deactivate the locking function—great for biking or physical therapy! The integrated, low profile joint provides the best in electronic stance control and helps patients achieve a more active lifestyle.

Simple onboard programming helps the E-MAG Active calibrate itself to the user’s unique gait pattern, adding a whole new dimension of functionality for people who previously have had limited bracing options, such as a locked knee or manual device. Help your patients get back into the swing of things with the E-MAG Active!

To learn more, contact your sales representative at 800/328-4058 or visit www.ottobockus.com.

THE LATEST INNOVATION IN FLEXIBLE SOCKET MATERIAL: POLYTOL®—BACKED BY EXPERT FABRICATION A flexible socket made with Otto Bock’s breakthrough PolyTol® material contours to the body with exceptional, long-lasting elasticity.

PolyTol is easy on your patient’s skin, with no irritating or allergenic components. The material offers good

moisture absorption and skin adhesion for an intimate and comfortable fit.

As the clinician, you also have the advantage of Otto Bock’s fabrication staff, experts who work with PolyTol every day and can give you just what you ordered, right when you need it, and at a cost with no surprises.

To learn more, contact your sales representative at 800/328-4058 or visit www.ottobockus.com.

PEL SUPPLY OFFERS IBEX™ FOOT SYSTEM The Fillauer Ibex™ Foot System is a leap forward in multi-axial foot design. The innovative microslices in the Ibex pylon and the split heel plate provide controlled inversion and eversion for terrain conformance. Its multi-axial design is energy optimized with a long carbon pylon and full length heel plate that allows the Ibex to reach foot flat sooner and to store more energy. Unique components of the Ibex work together from heel strike to toe off to provide stability without sacrificing energy return. Designed for patients up to 330 lbs, the Ibex weighs only 16.2 oz (459 g), with a built height of 6.75 in (17 cm). And now, the all new Ibex XD is rated for patients up to 440 lbs, with a weight of 21.2 oz (602 g) and a build height of 7.63 in (19 cm). Both meet the ISO-22675 test standard and offer a three-year warranty.

For more information on the Ibex and Ibex XD Foot System and other innovative new products from the Fillauer Companies, call your friendly PEL Customer Service Rep at 800/321-1264, fax 800/222-6176, email customerservice@pelsupply.com or order online at www.pelsupply.com.

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advancing the world of prosthetics — from the most sophisticated to the fundamental IPECS LAB SYSTEM Unlike any device on the market today, the iPecs™ Lab system is a portable research tool that provides accurate measurements of 3-axis forces and moments experienced by a prosthesis user – in any environment, without wires or the need for additional equipment.

By eliminating approximation and isolating the effects of the prosthetic system,the iPecs allows gait labs to capture true outcome data at the point of impact for cutting edge research results.

4-HOLE ROTATABLE ADAPTERS ((Patent-pending) Bringing a new twist to a standard device, our unique 4-hole adapters provide an infinite number of positions with a smooth, rotatable interface.

The adapter is rated to 125 kg yet built with light weight titanium, making it the strongest, lightest adapter on the market today. Not only does the adapter have an endless number of positions, it also maintains the set position when removing fasteners.

Just a few ways College Park brings you true innovation, from top to bottom.

individualized solutions. thousands of possibilities.

800.728.7950

I

www.college-park.com

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Marketplace

NEW WEIGHT RATINGS AND PRICING ON MODULAR COMPONENTS

SPS now has available an extended line of Otto Bock modular components with higher weight ratings at competitive pricing. Many of the additional structural components carry higher weight ratings for broader applications to a larger patient population.

The price of a significant number of components has been lowered to create a new standard of economic value in products of remarkably high quality.

Effective immediately, the additional Otto Bock products may be purchased through any of SPS’ four Distribution

Centers in Georgia, Texas, Califorrnia, and Pennsylvania or through Otto Bock directly as before. A complete catalog of Otto Bock products now available through SPS was mailed to SPS Customers in January 2011. If you have not received your copy, please contact Kim Martin (kmartin@spsco.com) at SPS via email to request a copy be forwarded to you.

For more information, contact SPS Customer Service at 800/767-7776 ext.

3 or your SPS Sales Manager.

ALPHA® ORIGINAL MP LINER: THE ORIGINAL IN COMFORT AND PROTECTION The Alpha Original MP Liner by WillowWood delivers comfort and protection of a residual limb and is the powerhouse core of the Alpha Liner family. The Alpha Original MP, available in locking and cushion, features a uniform gel style, green/gray fabric, and six mm gel thickness. These are the most popular Alpha Liners from WillowWood. The Alpha Original MP Liner has skinfriendly, mineral-oil-based Classic Gel that gently adheres to the skin and protects against abrasion and breakdown. The durable green/gray fabric helps extend the life of the liner.

For more information, contact WillowWood at 800/848-4930 or visit willowwoodco.com. a

Increase Earnings, Claims Fully Paid Dont, Wait for an Emergency, Proven Turnkey Billing Services Make Your Practice More Profitable “ No Learning software” “Automatic Electronic Document Storage” “All Payment Checks Come Directly to You”

Our customers have seen these results, You can too!

Stop chasing claims collect 10% to 30 % more today

• Increased collections • Decreased valuable staff load • Important patient functions get done •100% of your billing needs handled • 30 + years guidance in O & P Industry

“30 years of O & P experience and 10 years as a billing agency has taught me how to get results and save you hours and hours of unnecessary management.

Call me directly, toll free (866) 925-0674, so I can show you how easy it is to have us do your billing today.”. ...John Dolza, President CPO Services We make it easy for you to transition your billing to us with complete Satisfaction.

Complete Professional Office Services p. (810) 629-6424 - f. (810) 629-6463

www.oandpoffice.com

50

O&P ALMANAC MAY 2011

EEZZFFlex lex L Liner iner

PracticalMagic Magic Practical Hardlyjust justa apretty pretty Hardly face,theEZEZFlex FlexLiner Liner face,the deliversunequaled unequaledfunction function delivers withoutsacrificing sacrificinganything. anything. without Unified Flexible Front Unified Flexible Front

The unique on the The unique fabricfabric on the anterior surface provides anterior surface provides unlimited stretch unlimited stretch over over the the patella for greater elasticity patella for greater elasticity reducing pressure on the whilewhile reducing pressure on the andamount the amount of energy knee knee and the of energy required to the flexknee the knee required to flex

80% Less Vertical Stretch 80% Less Vertical Stretch Posteriorly Posteriorly

compared other Alps AsAs compared toto other Alps gelgel liners, virtually eliminating liners, virtually eliminating pistoning while minimizing pistoning while minimizing bunching behind the knee bunching behind the knee during flexion during flexion

Medial the knee in flexion Medial viewview of theofknee in flexion demonstrates the greater elasticity demonstrates the greater elasticity of the anterior fabric to extend of the anterior fabric to extend over over the front the knee.

Paring it with the front of theofknee.

Paring it with the limited vertical stretch posterior the limited vertical stretch posterior fabric reduces the overall fabric reduces the overall efforteffort expended byamputee the amputee to bend expended by the to bend the the and increases comfort. kneeknee and increases comfort.

Liner AlpsAlps NewNew EZ EZ FlexFlex Liner (anterior shown (anterior viewview shown above) is available above) is available in in 3mm or 6mm Uniform 3mm or 6mm Uniform thicknesses.

Eight sizes thicknesses.

Eight sizes fit circumferences of 16 fit circumferences of 16 to cm.

44 cm. cm cm to 44

NOW ININ STOCK: STOCK: NOW Experience Our Commitment

2009 ALPS.AllAll Rights Reserved. ŠŠ 2010 ALPS. Rights Reserved.

Antioxidants & EZ Antioxidants & EZ GelGel Protect Skin-Protect Skin--

Antioxidants EZhelp Gel help Antioxidants in EZin Gel protect the from skin from damage protect the skin damage caused by radicals. free radicals. caused by free is perfect for those ALPS ALPS EZGelEZGel is perfect for those skin characteristics with with poor poor skin characteristics or sensitive tissues. or sensitive tissues.

Budget Friendly-Budget Friendly--

No other onmarket the market No other liner liner on the provides this quality, durability provides this quality, durability and functionality at price... this price... and functionality at this absolutely no other! absolutely no other!

800.574.5426 800.574.5426 www.easyliner.com www.easyliner.com info@easyliner.com info@easyliner.com

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Jobs

INCREASE EXPOSURE AND SAVE!

Place your classified ad in the O&P Almanac and online on the O&P Job Board at jobs.AOPAnet.org and save 5 percent on your order. BONUS! Online listings highlighted in yellow in the O&P Almanac.

North Central Certified Prosthetist/Orthotist, Certified Orthotist, Board Certified Prosthetist Privately owned practice with a 50-year track record has an immediate opening in our large, Midwest facility. We’re looking for an orthotist or prosthetist who is good with patients, familiar with the latest technology, aggressive with patient care, and motivated to help us market our facility. We offer a competitive salary and health benefits.

Send resume to:

- Northeast - Mid-Atlantic - Southeast - North Central - Inter-Mountain - Pacific Use our map to find which region you fit into!

CLASSIFIED RATES Classified advertising rates are calculated by counting complete words. (Telephone and fax numbers, email and Web addresses are counted as single words.) AOPA member companies receive the member rate.

Member Non-member Words Rate Rate 50 or fewer words $140 $280 51-75 words $190 $380 76-120 words $260 $520 121 words or more $2.25 per word $5.00 per word Specials: 1/4 page, color

1/2 page, color

$482 $678 $634 $830

Advertisements and payments need to be received approximately one month prior to publication date in order to be printed in the magazine. Ads can be posted and updated at any point on the O&P Job Board online at jobs.AOPAnet.org.

No orders or cancellations are taken by phone.

Ads may be faxed to 571/431-0899 or emailed to srybicki@ AOPAnet.org., along with a VISA or MasterCard number, the name on the card and the expiration date. Typed advertisements and checks in U.S. currency made out to AOPA can be mailed to P.O. Box 34711, Alexandria, VA 22334-0711.

Note: AOPA reserves the right to edit Job listings for space and style considerations.

Responses to O&P box numbers are forwarded free of charge. Company logos are placed free of charge.

JOB BOARD RATES Visit the only online job Member Non-member board in the industry at Rate Rate jobs.AOPAnet.org! $80 $140 Save 5 percent on O&P Almanac classified rates by placing your ad in both the O&P Almanac and on the O&P Job Board, online at jobs.AOPAnet.org.

52

O&P ALMANAC MAY 2011

Email: mhcbl@aol.com Fax: 317/858-3146

CPO, CO, CP, BEO, BEP, C.Ped., Residents Peoria, Illinois Immediate openings and excellent opportunities for independent, motivated, and ABC certified practitioners for a well-established, multiple-location O&P practice in Illinois. The ideal candidate will be ABC certified and must be eligible for Illinois state licensure. We also would like to speak with candidates seeking residency in orthotics and prosthetics. Our fast-paced, energetic atmosphere is a rewarding place to establish a great career. We offer a very competitive salary and benefits package commensurate with experience. If you have what it takes to be a part of a successful and well organized team then we would love to speak with you. Management experience is a plus! Multiple locations available. Forward your resume, in confidence, to:

Recruitment Manager Comprehensive Prosthetics & Orthotics, Inc. 741 West Main Street Peoria, Illinois, 61606 Fax: 309/676-2279 Email: careers@cpousa.com

Northeast

Mid-Atlantic Certified Prosthetist/Orthotist

Certified Prosthetist

Philadelphia Culture, arts, history and architecture … not to mention cuisine! Philly has it all! It is the country’s fifth-largest city comprised of art museums and galleries, serious shopping, all four major sports, University of PA. And, can’t forget the Philly Cheese Steak! If you want more than a job and are ready to make a move, we would love to discuss your goals.

We offer a very competitive salary and benefit package accompanied by relocation assistance and sign-on bonus potential … plus much more. If interested, please contact, in confidence:

Vermont Yankee Medical, providing orthotic and prosthetic services for more than 64 years, is looking for a certified prosthetist ready to relocate to Vermont.

With five locations in some of the most scenic areas of the country, Yankee Medical offers a lifestyle that attracts professionals. Send resume to:

Sharon King Hanger Prosthetics & Orthotics, Inc. Phone: 512/777-3814 Fax: 512/777-3772 Email: sking@hanger.com www.hanger.com/careers

Attn: President, Yankee Medical 276 North Avenue, Burlington, VT 05401 Email: jnf@yankeemedical.com

Orthotic Technician Mid-Hudson Valley, New York Established and independently owned O&P company has an immediate opening for a motivated and skilled technician.

Must be able to learn new fabrication techniques quickly and keep pace with a busy work load. Three or more years experience preferred. Great work environment, wages, and benefits, please fax resume to:

ATTN: Job Board, Fax: 571/431-0899

AVAILABLE POSITIONS Orthotist

Why do I work for Hanger?

“

I like working for a company that cares for its employees as much as they care for their patients. That’s why I’ve been with Hanger for the past 28 years.

When Hurricane Katrina hit my hometown of New Orleans, Hanger was there for me. They gave me as much time as I needed—with pay—and helped me relocate to Atlanta.

By working at the largest prosthetic and orthotic company in the nation, I have more than just career opportunities.

I have an employer that treats me like family.

”

Tony Thaxton Jr., CPO, LPO, Certified Practitioner, Orthotist-Prosthetist

Folsom, CA Pensacola, FL Griffin, GA Joliet, IL Mt. Vernon, IL Urbana, IL Evansville, IN Indianapolis, IN

Iowa City, IA Paducah, KY Methuen, MA Tahlequah, OK Alliance/Akron, OH York, PA Spartanburg/Union, SC

Prosthetist

American Canyon / Fairfield, Albany, NY CA Enid, OK Jackson, MS Austin, TX

Prosthetist/Orthotist

American Canyon / Fairfield, CA Long Beach, CA Denver, CO Thornton, CO Pensacola, FL Indianapolis, IN Michigan City, IN Des Moines, IA

Dubuque, IA Baltimore, MD Meridian, MS Albany, NY Akron, OH Bend, OR Salem, OR Philadelphia, PA Memphis, TN

Certified Pedorthist

Springfield, IL Willoughby, OH Tahlequah, OK

To apply for any of these positions, visit www.hanger.com/careers Hanger Orthopedic Group, Inc. is committed to providing equal employment to all qualified individuals. All conditions of employment are administered without discrimination due to race, color, religion, national origin, sex, age, disability, veteran status, citizenship, or any

other basis prohibited by federal, state or local law. Residency Program or Certificate Primary Education Program Info, contact: Robert S. Lin, CPO/Dir. of Academic Programs. Hanger P&O/ Newington O&P Systems, Ph. 860.667.5304; Fax 860.667.1719

Olympia / Vancouver, WA Tacoma / Renton, WA

Orthotist/Certified Pedorthist

Mt. Vernon, IL

Entry Level Torrance, CA

MAY 2011 O&P ALMANAC

53

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Jobs Southeast

CPO Birmingham, Alabama We have an immediate opening for a certified orthotist/ prosthetist to join our well-established practice in Birmingham, Alabama. The ideal candidate must have or be eligible for Alabama State licensure. The ideal candidate also should possess at least three years of broad experience in orthotics/prosthetics. Fabrication skills are desired. We offer a competitive salary based on experience, and benefits including health insurance, vacation, personal time, and 401(k). Forward your resume, in confidence, to:

Eric S. Eisenberg, MS, CPO BioTech Limb & Brace, LLC 2421 4th Avenue South Birmingham, AL 35233 Phone: 205/324-7897 Fax: 205/324-7899 Email: eseisenberg@msn.com

Inter-Mountain Certified Orthotist, Certified Prosthetist (licensed or eligible) Houston Energy capital of the world; voted first in Texas and third in the United States for “Best Places for Business and Careers”; known for the youngest population in the nation; the Houston Livestock Show and Rodeo; ZZ Top, Lyle Lovett, Clint Black, Hilary Duff, Blue October; NASA’s Lyndon B. Johnson Space Center; many parks and outdoor venues!

Considered by many to be one of the premier practices in the country. This position will challenge the successful applicant with a broad exposure to a diverse patient population. If you want more than a job and are ready to make a move, we would love to discuss your goals. We offer a very competitive salary and benefit package accompanied by relocation assistance and sign-on bonus potential … plus much more!

To apply for this position, please contact, in confidence:

Certified Orthotist/Certified Prosthetist Orthotist Charlotte, North Carolina Welcome to Charlotte, North Carolina, the largest metropolitan area in North Carolina. Charlotte is rich in history, culture and southern hospitality. If you are looking for city life or country living we have it here. Advanced Prosthetics and Orthotics, LLC is committed to providing intelligent and compassionate care; utilizing our role as an effective member of the rehabilitation team. We are a well-established ABC-accredited facility seeking an experienced CO/CPO for the Charlotte, North Carolina area. Candidates must be self-motivated, comfortable in a variety of clinical settings, and have excellent communication and organizational skills.

Please submit resume via fax or email:

Fax: 704/510-1311 Email: apocharlotte@birch.net Visit: www.advancedpros.com

Certified Prosthetist-Orthotist/Certified Orthotist/Board Eligible Chattanooga, Tennessee Private practice with a 10-year track record has an immediate opening for a CO or CPO. The successful candidate needs good patient care and communication skills, and must be motivated to help us grow. Competitive salary and profit sharing offered. Please submit resume/salary history to:

Dynamic Prosthetic & Orthotic, LLC 2116 McCallie Avenue Chattanooga, TN 37404

54

O&P ALMANAC MAY 2011

Sharon King Phone: 512/777-3814 Email: sking@hanger.com www.hanger.com/careers

Certified Prosthetist-Othotist/Certified Orthotist Denham Springs, Louisiana Immediate opening for a CPO/CO with prosthetic experience with a minimum of eight years experience.

Freedom Prosthetics is a rapidly growing business in the heart of Louisiana’s hunting and fishing paradise. We offer a competitive salary with benefits. Interested candidates, please forward resumes to:

Freedom Prosthetics LLC 8369 Florida Boulevard Suite 7 Denham Springs, LA 70726 Fax: 225/665-0319 Email: freedompros@bellsouth.net

Pacific Certified Orthotist, Certified Prosthetist, or Certified Prosthetist-Orthotist

Come Join Our Team!

Shriners Hospitals for Children® is a one-of-akind international system of 22 hospitals dedicated to improving the lives of children by providing specialty pediatric care, innovative research, and outstanding teaching programs. Children up to age 18 with orthpaedic conditions, spinal cord injuries, and limb deficiencies are eligible for admission, care, and treatment regardless of financial need or relationship to a Shriner.

With recent program development and an expanding operative schedule we are anticipating a need to expand our O&P service to meet the need of our patients and hospital.

Fresno and Monterey Bay Area, California Growing western states O&P business seeking certified CO, CP, or CPO for excellent opportunities in Fresno, California, and the Monterey Bay Area, California. Unlimited business opportunities available in an expanding local market.

Competitive salary, benefits, and profit sharing as the business grows.

Interested parties should email inquiries/resume to:

Email: jwiley@pacmedical.com Fax: 888/853-0002

O&P Practitioner Works with a multi-disciplinary care team to determine, design, fabricate, fit, and evaluate the effectiveness of orthoses and prostheses for children with orthopedic impairments, spinal cord injuries, and limb deficiencies. Engages in evidence-based practice related to the field of orthotics, prosthetics, neuroprosthetics, and rehabilitation. Supports and actively engages in performance improvement initiatives and research.

Undergraduate degree in O&P, allied health field, engineering, kinesiology, biology or biomechanics preferred. Experience in prosthetics and/or orthotics as evidenced by successful completion of an accredited prosthetic and/or orthotic program with certification by the American Board for Certification in Orthotics and Prosthetics. At least three years of experience preferred. Strong interest in working with children and families is a must.

Call, fax or email inquires to:

Megan Hauser Shriners Hospitals for Children®-Philadelphia 3551 North Broad Street Philadelphia, PA 19140 Phone: 215/430-4061 Fax: 215/430-4180 Email: hr_phila@shrinenet.org

CO or CPO Marshfield Clinic is one of the largest patient care, research and educational systems in the United States. The Marshfield Clinic’s Orthotic and Prosthetic department is dedicated to helping patients regain their active lifestyles and live life without limitations.

Our department offers the newest advancements in orthotic, prosthetic and pedorthic technology combined with friendly, highly skilled and experienced staff that is committed to the highest quality patient care.

Discover Marshfield, Wisconsin & enjoy:

• Low cost of living • Clean, safe environment • Short commutes with low traffic volume • Excellent educational opportunities for both you and your family • Recreational & cultural activities during all four seasons • Easy access to urban centers at Chicago, Madison, Milwaukee or Minneapolis/St. Paul • Competitive total compensation package

ABC Certified in Orthotics & Prosthetics and 3 years of experience required.

Experience in Pediatrics would be helpful.

Join us and see how your career can shine.

To apply, please visit:

www.marshfieldclinic.jobs Reference Job Number MC090202 Marshfield Clinic is an Affirmative Action/Equal Opportunity Employer that values diversity. Minorities, females, individuals with disabilities and veterans are encouraged to apply.

MAY 2011 O&P ALMANAC

55

Classroom Education

MASTERING MEDICARE: Advanced Coding & Billing Techniques Seminar

Gas Las VE nIO nTO san a ORE BaLTIM

An intensive two-day workshop for O&P practitioners and office billing staff EaRn

14 dCITEs CREPER

AR

SEMIN

Master coding and billing for the most difficult devices without the panic that may have plagued you in the past! Led

by Joe McTernan, AOPA Medicare expert; Brian L. Gustin, CP; and Jonathan M. Naft, CPO, this seminar gives you the tips and hands-on experience you need to get paid for all of your O&P services.

Upon completion, you will receive 14 continuing education credits and a certificate to take back to the office to display your newly developed coding and billing skills. Attendees receive a free manual that contains comprehensive information on coding and billing. This will not only serve as a guide for the seminar, but is also an effective tool that can be utilized outside of the seminar.

Three locations to serve you in 2011––

May 19-20

The Mirage Resort, Las Vegas, NV

In the breakout session Practitioners will learn: • Coding principles • How to code complex devices • Coding of repairs and adjustments

JuNe 16-17

• Usage of ‘99 codes

San antonio Marriott Rivercenter, San antonio, TX

• Mutually exclusive codes In the breakout session administrators will learn: • How to comply with the Quality and Supplier Standards • Strategies for handling appeals and denials • How to handle unique billing situations • Documentation requirements • Billing for Medicare as secondary payer

OcT 24-25

everyone will cover:

Sheraton Inner Harbor, Baltimore, MD

• Medicare’s Medical Policies • Hints on better documentation • How to create a compliance plan • How to audit your charts

Don’t miss these upcoming opportunities! obtain more information and register online at www.aOPanet.org

n

Jobs Certified Prosthetist-Orthotist

Pacific

Southern California Do you want to work for an established, growing company in an environment that values clinical excellence and work/life balance? Do you want to live in one of the most desired and diverse areas in the country, beautiful Southern California? SCOPe has a career opportunity for you. We are a leading orthotics and prosthetics company looking for an energetic and motivated CPO to provide comprehensive assessment, treatment, and follow-up for our patients. SCOPe offers competitive salaries as well as an excellent benefits package for full time employees. Salary is commensurate with experience. Interested parties can send resumes via email to:

Certified Orthotist Northern California Do you dream of earning six figures? Receiving a significant sign-on bonus and to work for the oldest and one of the most respected orthotic and prosthetic patient care companies in the world? Are you looking for security? In addition to the above, we offer competitive benefits, world-class education fair, latest technology and a family of more than 1,000 practitioners in addition to the support of HR, sales/marketing, accounting, etc. Our core values are: • Integrity • Clinical and operational excellence • Unsurpassed customer satisfaction • Flexible and entrepreneurial operations • Creativity and innovation • Shared success.

If you have the skills, drive and ambition … let’s talk!

Contact, in confidence:

Fax to 858/292-5496 Email: jobs@scop.net www.scop.net All communications will be held in the strictest confidence.

Sharon King Phone: 512/777-3814 Email: sking@hanger.com www.hanger.com/careers

O&P Board Study Resources We can help you PASS your BOARDS All products updated to 2011 test standards.

The ONLY Comprehensive Study Guides Specifically for Orthotics and Prosthetics

(Many of our products are available in DVD Format also!)

JUST ADDED: The MASTECTOMY FITTER’s Review and Study Guide We also have Board Study Value Packages in Orthotics and Prosthetics Check out your readiness to sit for your boards with our Clinical Practice Exams.

Our BEST SELLING products to save you money!

www.oandpstudyguide.com MAY 2011 O&P ALMANAC

57

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Calendar

2011 ■■

PROMOTE EVENTS IN THE O&P ALMANAC

CALENDAR RATES Telephone and fax numbers, email addresses and Web sites are counted as single words. Refer to www.AOPAnet.org for content deadlines.

Member Non-member Words Rate Rate 25 or less $40 $50 26-50 $50 $60 51+ $2.25 $3.00

per word per word Color Ad Special: 1/4 page Ad $482 1/2 page Ad $634

$678 $830

BONUS! Listings will be placed free of charge on the Attend O&P Events section of www.AOPAnet.org.

Send announcement and payment to: O&P Almanac, Calendar, P.O. Box 34711, Alexandria, VA 22334-0711, fax 571/431-0899, or email srybicki@AOPAnet.org along with VISA or MasterCard number, the name on the card, and expiration date. Make checks payable in U.S. currency to AOPA. Note: AOPA reserves the right to edit Calendar listings for space and style considerations.

For information on continuing education credits, contact the sponsor.

Questions?

Email srybicki@AOPAnet.org.

58

O&P ALMANAC MAY 2011

■■ MAY 6-7 The Northwest Chapter of the American Academy of Orthotists & Prosthetists.

Seattle. The Bellevue Courtyard by Marriott Hotel.

For information contact Tim Shride, CPO, LPO, at 612/2030936 or nwaaop@gmail.com or visit www.regonline.com/ nwaaop_2011.

■■ MAY 10 WillowWood: Discover LimbLogic® VS via WebEx, 1:30 pm ET. Critical components and operation discussed. Covers interpreting feedback from fob and basic fabrication processes for system. Credits: 2.5 ABC/2.5 BOC. To register online, visit www.willowwoodco.com.

■■ MAY 11 AOPA Audio Conference: “Which Box to Check?

The Negative Effect of the 855S on Reimbursement.”

To register, contact Ann Davis at 571/431-0876 or adavis@AOPAnet.org.

■■ MAY 11 WillowWood: LimbLogic® VS for Technicians via WebEx, 1:30 pm ET. Learn essentials of elevated vacuum socket fabrication using available socket adaptors with LimbLogic VS. Learn how to deal with airtight issues, unit operation, and diagnostics that will keep the system optimal for patient use.

Credits: 2.5 ABC/2.5 BOC. Visit www.willowwoodco.com.

■■ MAY 11 Ultraflex: Pediatric Spasticity Continuing Education Course, via WebEx, 5:00 – 6:00 pm ET. Covers clinical assessment of the pediatric neuromuscular patient with spasticity and using R1 and

R2 for determining orthotic design for maintaining and improving muscle length.

Presenter: Keith Smith, CO, LO, FAAOP. To register, call 800/220-6670 or visit www. ultraflexsystems.com.

■■ MAY 11-14 PA Academy of Orthotic & Prosthetics Spring Conference. Pittsburgh.

Sheraton Station Square.

Contact Beth Cornelius or Joseph Carter at 814/455-5383.

■■ MAY 12–14 Western and Midwestern Orthotic Prosthetic Association/California Orthotic and Prosthetic Association Annual Meeting.

Reno, NV. (New) Peppermill Hotel. Contact Steve Colwell at 206/440-1811 or Sharon Gomez at 530/521-4541 or visit www.wamopa.com.

■■ MAY 14 Arizona AFO Inc: The Custom AFO Workshop.

Chicago. Learn L-Coding, AFO selection, hands-on casting, footwear/modification tips and ideas for marketing to referral sources. The $150 fee includes lectures, handouts, and lunch. Approved for 6.5 ABC/7 BOC CEUs. To register, call 877/780-8382, ask for the “Workshop” or email education@arizonaafo.com.

■■ MAY 14 Ultraflex: Pediatric UltraSafeGait™ Continuing Education Course, via WebEx, 9:00 – 10:00 am ET. Covers assessment of pediatric pathological gait and influencing shank kinematics with the new Adjustable Dynamic Response™ (ADR™) technology. Presenter: Keith Smith, CO, LO, FAAOP. To register, call 800/220-6670 or visit www.ultraflexsystems.com.

■■ MAY 19-20 WillowWood: Existing OMEGA® Tracer® Users Orthotics and Prosthetics

Course. Mt. Sterling, OH. Advanced course covers OMEGA Scanner use, modifying orthotic and prosthetic shapes, and review of custom liner, cranial, and spinal software. Must be current OMEGA Tracer facility to attend. Credits: 14.25 ABC/15.5 BOC. www.willowwoodco.com.

■■ MAY 24 Ultraflex: Adult UltraSafeStep™ Continuing Education Course, via WebEx, Noon – 1:00 pm ET. Focuses on normalizing adult pathological gait with the utilization of Adjustable Dynamic Response™ (ADR™) knee and ankle technology. To register, call 800/220-6670 or visit www.ultraflexsystems.com.

■■ MAY 26 Ultraflex: Complex Orthopedic Rehabilitation Continuing Education Course, via WebEx, Noon – 1:00 pm ET. Focuses on Ultraflex combination dynamic and static stretching orthosis for addressing complex orthopedic rehabilitation goals and restoring range and function. To register, call 800/220-6670 or visit www.ultraflexsystems.com.

■■ JUNE 1 Ultraflex: Pediatric Spasticity Continuing Education Course, via WebEx, 8:00 – 9:00 am ET. Covers clinical assessment of the pediatric neuromuscular patient with spasticity and using R1 and R2 for determining orthotic design for maintaining and improving muscle length.

Presenter: Keith Smith, CO, LO, FAAOP. To register, call 800/220-6670 or visit www. ultraflexsystems.com.

■■ JUNE 3–4 PrimeFare East Regional Scientific Symposium 2011. Nashville. Nashville Convention Center. Contact Jane Edwards at 888/388-5243 or visit www.primecareop.com.

ATTEND THE PREMIER O&P EVENT OF THE YEAR: THE 2011 AOPA NATIONAL ASSEMBLY We look forward to seeing you at the AOPA 2011 National Assembly September 19-22, 2011, at The Mirage Resort & Casino in Las Vegas!

THE MIRAGE—THE PLACE TO BE FOR THE PREMIER O&P EDUCATION EVENT OF THE YEAR! •

Exceptional $135 room rate at The Mirage Resort & Casino— AAA-Four Diamond Resort

•

Unprecedented business education featuring experts in health care reform, documentation, O&P business management, ethics, different business models, new round table discussions and more.

•

Experience the country’s largest and oldest trade show for the orthotics, prosthetics and pedorthics profession.

[ THE E C E PLTA OB

•

34 Continuing Education (CE) Credits applied for.

•

Scientific programs featuring an extensive symposium on treating spinal trauma with live demonstrations and futuristic topics such as osseo integration, robotics, stroke management, wound care and material science.

•

Fabulous shopping, entertainment, championship golf and unparalleled people watching—all of this right in the heart of the Las Vegas Strip!

SAVE THE DATE SEPTEMBER 19-22, 2011

]

Visit www.AOPAnet.org for updates on education and events.

AMERICAN ORTHOTIC & PROSTHETIC ASSOCIATION

Business OpTimizATiOn AnAlysis TOOl (BOAT) AOPA’s largest and most successful members use the BOAT and you should also.

The BOAT will help you:

This AmAzing Profit Booster is FREE for AoPA MeMbers.

You will have access to your own secure and confidential account on the BOAT which will contain your company’s reported data and is specifically tailored to help O&P business owners manage their business for

•

Create budgets

•

Track your finances

•

Participate in the annual Operating Performance and Compensation survey (OPC)—which provides you with a personal benchmark comparison study

•

OPC data you submit will automatically populate your BOAT site providing valuable historical information

•

Provide access to the new AOPA Patient Satisfaction Survey (required by certifying bodies)

•

Examine the financial fitness of your business

•

Help you identify and understand your competition, market conditions and referral sources

•

Much more!

3

Enroll Today!

greATer prOfiT And quAliTy pATienT cAre.

If you do not already have a BOAT account, contact AOPA’s BOAT partner, Michael Becher, Industry Insights, (614)389-2100 x 114 or mbecher@industryinsights.com, to enroll today.

n

Calendar

■■ JUNE 6-7 Allard USA: T.O.T.E. (Tomorrow’s Orthotic Technology Education).

Little Rock, AR. Two courses: Concepts in Applied Biomechanics; Transferring CAB Principles into Customized Orthotic Solutions. 18 CEUs Pending.

Contact 888/678-6548 or email: info@allardusa.com.

■■ JUNE 8 AOPA Audio Conference: “Preventing Audit Disasters.”

To register contact Ann Davis at 571/431-0876 or adavis@ AOPAnet.org.

■■ JUNE 8 Ultraflex: Pediatric UltraSafeGait™ Continuing Education Course, via WebEx, 5:00 – 6:00 pm ET. Covers assessment of pediatric pathological gait and influencing shank kinematics with the new Adjustable Dynamic Response™ (ADR™) technology. Presenter: Keith Smith, CO, LO. To register, call 800/220-6670 or visit www. ultraflexsystems.com.

■■ JUNE 9-10 Michigan Orthotics & Prosthetics Association (MOPA) Continuing Education Meeting. Mt. Pleasant, MI. Soaring Eagle Casino & Resort. Contact Mary Ellen Kitzman, 248/6150600, MOPA_meeting@mopa. info or visit www.mopa.info.

JUNE 9 Hosmer Upper Extremity Seminar. Los Gatos, CA. Comprehensive seminar on upper extremity prosthetics.

Areas the seminar will focus on are alternative upper extremity componentry, impression techniques and harnessing. Learning objectives will include familiarization with work sources, biomechanics,

componentry adjustment, and prosthetic optimization.

To register, contact Jackie Bradford at 800/827-0070 or jbradford@hosmer.com.

configurations, fob operation, system evaluation, liner options, alignment, and troubleshooting. Credits: 7.25 ABC/7.75 BOC. Registration deadline: 5/26/2011. Contact: 877.665.5443 or visit www.

willowwoodco.com JUNE 10 Advanced Lower Extremity Design Seminar. Los Gatos, CA. The seminar will examine the development of current composite dynamic foot and microprocessor knee systems with respect to biomechanics, physiologic function, and functional design classification.

Attendees will receive handson demonstrations that allow them to experience the new feet and knee designs first hand. To register, contact Jackie Bradford at 800/8270070 or jbradford@hosmer.com.

■■

■■ JUNE 13-17 Applied Technology Institute (ATi) Orthotic Fitter School, CSUDH Center for Orthotics and Prosthetics. Long Beach, CA. Independent comprehensive course to prepare for certification exam. Approved entry level school by NCOPE (ABC), and BOC; and for continuing education by ABC, BOC, and NATA. Contact Lois Meier at 888/265-6077 or lois@ kasseledu.com or visit www. kasseledu.com.

■■ JUNE 17 WillowWood: LimbLogic® VS Applications Technicians Course. Mt. Sterling, OH. Learn all aspects of fabricating LimbLogic VS for various applications: socket materials, controller configurations and care, fob operation, troubleshooting.

Fabricate sockets following recommended techniques for airtight socket designs.

Credits: 9.75 ABC/9.75 BOC. Registration deadline: 5/26/2011. Contact 877/6655443 or visit www.willowwoodco. com.

■■ JUNE 20-21 Allard USA: T.O.T.E. (Tomorrow’s Orthotic Technology Education).

Louisville, KY. Two courses: Concepts in Applied Biomechanics; Transferring CAB Principles into Customized Orthotic Solutions. 18 CEUs Pending.

Contact 888/678-6548 or email info@allardusa.com.

■■ JUNE 23-24 WillowWood: Existing OMEGA® Tracer® Users Orthotics and Prosthetics Course. Mt. Sterling, OH. Advanced course covers OMEGA Scanner use, modifying orthotic and prosthetic shapes, and review of custom liner, cranial, and spinal software. Must be current OMEGA Tracer facility to attend. Credits: 14.25 ABC/15.5 BOC or visit www. willowwoodco.com.

2011 Advanced Lower Extremity Prosthetic Design Seminars MAY 18

AUGUST 3

JUNE 10

AUGUST 19

Houston, TX Los Gatos, CA

Baltimore, MD St. Louis, MO

JUNE 13

Santa Ana, CA For more information regarding the seminars listed or to register, please contact Nicki Cantrell at 800-251-6398 or ncantrell@fillauer.com

■■

■■ JUNE 16 WillowWood: LimbLogic® VS Applications Practitioner Course. Mt. Sterling, OH. Course covers various clinical aspects of LimbLogic VS applications: static and dynamic socket fitting, vacuum pump

AD309 04-04-11

MAY 2011 O&P ALMANAC

61

n

Calendar

■■ JUNE 27-28 Allard USA: T.O.T.E. (Tomorrow’s Orthotic Technology Education).

Denver. Two courses: Concepts in Applied Biomechanics; Transferring CAB Principles into Customized Orthotic Solutions. 18 CEUs Pending.

Contact 888/678-6548 or email info@allardusa.com.

■■ JULY 13 AOPA Audio Conference: “Don’t Rile the OSHA Police.” To register contact Ann Davis at 571/431-0876 or adavis@AOPAnet.org.

JULY 18-19 Reciprocal Gait Orthosis Advanced Seminar.

Chattanooga, TN. Fillauer LLC and Center for Orthotics Design hosts a seminar on the Reciprocal Gait Orthosis.

Be a part of the team that enables a spinal cord injury or congenital birth defect patient to leave their wheelchair and walk with a natural gait, regain independence, and make a difference in their lives. Contact Nicki Cantrell at 800/251-6398 or ncantrell@ fillauer.com.

■■

■■ JULY 21-22 Allard USA: T.O.T.E. (Tomorrow’s Orthotic Technology Education).

Springfield, MA. Two courses: Concepts in Applied Biomechanics; Transferring CAB Principles into Customized Orthotic Solutions. 18 CEUs Pending.

Contact 888/678-6548 or email info@allardusa.com.

■■ JULY 28-29 Allard USA: T.O.T.E. (Tomorrow’s Orthotic Technology Education).

San Antonio. Two courses:

62

O&P ALMANAC MAY 2011

Concepts in Applied Biomechanics; Transferring CAB Principles into Customized Orthotic Solutions. 18 CEUs Pending.

Contact 888/678-6548 or email info@allardusa.com.

■■ AUGUST 5-6 Texas Chapter of the American Academy of Orthotist and Prosthetist (TCAAOP) Annual Meeting and Scientific Symposium.

Sheraton Austin Hotel at the Capitol, Austin. For more information, go to www. txaaop.org or contact Suzanne O’connor at 972/953-0860 or suzanne.oconnor@cpocare.com.

■■ AUGUST 10 AOPA Audio Conference: “How to Get Paid for Miscellaneous and Repair Codes.” To register, contact Ann Davis at 571/431-0876 or adavis@AOPAnet.org.

■■ SEPTEMBER 14 AOPA Audio Conference: “Don’t Run Afoul of the KO Rules.” To register, contact Ann Davis at 571/431-0876 or adavis@AOPAnet.org.

■■ NOVEMBER 9 AOPA Audio Conference: “Happy Holidays: Kickbacks and Gifts in O&P.” To register, contact Ann Davis at 571/4310876 or adavis@AOPAnet.org.

■■ SEPTEMBER 19–22 AOPA National Assembly.

Las Vegas. Mirage Hotel. Exhibitors and sponsorship opportunities, contact Kelly O’Neill, 571/431-0852, or koneill@ AOPAnet.org.

■■ NOVEMBER 19 Arizona AFO Inc: The Custom AFO Workshop.

Phoenix. Learn L-Coding, AFO selection, handson casting, footwear/ modification tips and ideas for marketing to referral sources. The $150 fee includes lectures, handouts, and lunch.

Approved for 6.5 ABC/7 BOC CEUs. To register, call 877/780-8382, ask for the “Workshop,” or email education@arizonaafo.com.

OCTOBER 12 AOPA Audio Conference: “Developing Your Medicare Billing Compliance Plan.” To register, contact Ann Davis at 571/431-0876 or adavis@ AOPAnet.org.

■■

■■ AUGUST 11-12 Allard USA: T.O.T.E. (Tomorrow’s Orthotic Technology Education).

Ft. Lauderdale, FL. Two courses: Concepts in Applied Biomechanics; Transferring CAB Principles into Customized Orthotic Solutions. Approved for 18 CEU’s. Contact 888/678-6548 or email info@allardusa.com.

■■ OCTOBER 12-16 Skills for Life 3: Bilateral Upper Limb Loss Workshop.

Denver. Denver Renaissance Hotel. US Member SocietyISPO, Amputee Services of America, and the Amputee Coalition. For more information, visit www.usispo.org/skills_for_life. asp.

■■ AUGUST 13 Arizona AFO Inc: The Custom AFO Workshop.

Atlanta. Learn L-Coding, AFO selection, hands-on casting, footwear/modification tips and ideas for marketing to referral sources.

The $150 fee includes lectures, handouts, and lunch.

Approved for 6.5 ABC/7 BOC CEUs. To register, call 877/780-8382, ask for the “Workshop,” or email education@arizonaafo.com.

■■ OCTOBER 15 Arizona AFO Inc: The Custom AFO Workshop.

San Jose, CA. Learn L-Coding, AFO selection, hands-on casting, footwear/ modification and ideas for marketing to referral sources. The $150 fee includes lectures, handouts, and lunch.

Approved for 6.5 ABC/7 BOC CEUs. To register, call 877/780-8382, ask for the “Workshop,” or email education@arizonaafo.com.

■■ DECEMBER 14 AOPA Audio Conference: “Are You Ready for the New Year? 2012 New Codes and Policies.” To register, contact Ann Davis at 571/431-0876 or adavis@AOPAnet.org.

2012 ■■ MARCH 21–24 38th Academy Annual Meeting & Scientific Symposium. Atlanta. Hilton Atlanta. Contact Diane Ragusa at 202/380-3663, ext. 208 or dragusa@oandp.org.

2013 ■■ FEBRUARY 20–23 39th Academy Annual Meeting & Scientific Symposium. Orlando. Caribe Royale Orlando. Contact Diane Ragusa at 202/380-3663, ext. 208 or dragusa@oandp. org. a

n

Ad Index

COMPANY

PAGE

PHONE

WEB SITE OR EMAIL

Allard USA Inc.

15

888/678-6548

www.allardusa.com

ALPS

51

800/574-5426

www.easyliner.com

Orthotics, Prosthetics & Pedorthics

17

703/836-7114

www.abcop.org

Apis Footwear

35

888/937-2747

www.bigwideshoes.com

Arizona AFO

23

877/780-8382

www.arizonaafo.com

BOC International

45

877/776-2200

www.bocinternational.org

Cailor Fleming Insurance

29

800/796-8495

www.cailorfleming.com

College Park Industries Inc.

13, 49

800/728-7950

www.college-park.com

Complete Professional Office Services

50

810/629-6424

www.oandpoffice.com

DAW Industries

1

800/252-2828

www.daw-usa.com

Dr. Comfort

5, C3

800/556-5572

www.drcomfortdpm.com

Euro International

11

800/378-2480

www.eurointl.com

Ferrier Coupler Inc.

25

800/437-8597

www.ferrier.coupler.com

Fillauer Companies Inc.

33

800/251-6398

www.fillauercompanies.com

KISS Technologies LLC

42

410/663-5477

www.kiss-suspension.com

KNIT-RITE

2

800/821-3094

www.knitrite.com

OPTEC

6, 7

888/982-8181

www.optecusa.com

American Board for Certification in

Ossur Americas Inc.

37, C4

800/233-6263

www.ossur.com

Otto Bock HealthCare

C2

800/328-4058

www.ottobockus.com

PEL Supply Company

39

800/321-1264

www.pelsupply.com

SPS

9

800/767-7776 Ext. 3

www.spsco.com

®

AOPA PRESENTS

Expert Coding Advice 24/7 at www.LCodeSearch.com

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MAY 2011 O&P ALMANAC

63

n

AOPA Answers

Prep Codes Members question reimbursement denials for preparatory protheses

AOPA receives hundreds of queries from readers and members who have questions about some aspect of the O&P industry. Each month, we’ll share several of these questions and answers from AOPA’s expert staff with readers.

If you would like to submit a question to AOPA for possible inclusion in the department, email Editor Josephine Rossi at jrossi@strattonpublishing.com.

Q:

I keep getting denials from Medicare when I bill for an acrylic socket on a preparatory prosthesis.

I have excellent documentation regarding the need for the extra strength that the acrylic lamination provides. How do I get Medicare to pay for this code?

A:

Unfortunately, according to the current Medicare Lower Limb Prosthesis Local Coverage Determination (LCD), codes that describe an acrylic socket (L5629, L5631) will be denied as not medically necessary when billed in conjunction with an initial or preparatory base code. While there may be individual cases where an acrylic socket may indeed be medically necessary for a patient’s preparatory prosthesis, the only way to obtain reimbursement for these specific cases is through the appeals process. All of the DME MACs should have claim edits in place that will automatically deny L5629 or L5631 as not medically necessary when billed as an addition code to a preparatory base code.

Q:

I am seeing a lot of Medicare denials for the ultra light material codes (L5940-L5960) when they are billed with preparatory base codes. I have reviewed the Lower Limb Prosthesis LCD and Policy Article and these codes are not included in the list of codes that will be denied as not medically necessary when billed with an initial or preparatory prosthesis. Why is Medicare denying these codes?

A:

Last year, CMS altered its opinion on the proper use of the ultra light material codes. For many years, policy stated that the ultra light material codes were only to

64

O&P ALMANAC MAY 2011

be used to describe ultra light components of a prosthesis that did not include the socket. Effective with the April 1, 2010 Policy Article, CMS reversed its opinion on the use of the ultra light codes and stated that they were only to be billed when material used in the fabrication of the socket was ultra light in nature. CMS also issued instructions to the DME MACs that advised them to create system edits that only allowed codes L5940-L5960 to be billed in conjunction with definitive base procedure codes and socket replacement codes. These instructions are most likely the cause for the denial of the ultra light codes when billing a preparatory device. You are correct, however, that the current Lower Limb Prosthesis LCD and Policy Article do not prohibit billing for ultra light material when providing a preparatory base code. This fact establishes grounds for an appeal based on the argument that policy does not indicate that ultra light materials are not medically necessary when used in the fabrication of a preparatory prosthesis. a

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