I am trying to understand the mechanics of the way that practitioners make money off the CTP/skin sub itself. In principle it sounds straightforward, but in reality, “it’s complicated.”
A clinician sent me these 2 invoices for the same amniotic product applied in the doctor’s office. The invoice number is the same on both documents. In other words, there are two invoices for the same product. The product number is the same, although I have redacted the product information.
One invoice shows the full price of the product at $15,200 and the other shows the discounted price at $9,120.00. That means the clinician could “take home” $6,080.00 for this 4×4 amnion, depending on how much they actually paid the company and how much they got reimbursed by Medicare.
Can anyone explain how this dual invoice system could be used to line the pocket of a practitioner?
Dr. Fife is a world renowned wound care physician dedicated to improving patient outcomes through quality driven care. Please visit my blog at CarolineFifeMD.com and my Youtube channel at https://www.youtube.com/c/carolinefifemd/videos
The opinions, comments, and content expressed or implied in my statements are solely my own and do not necessarily reflect the position or views of Intellicure or any of the boards on which I serve.
There should be no invoice system. CMS should set a fixed rate for supply costs for all providers outside of the OPPS, regardless of the CTP used. This would reveal which CTPs physicians and mobile wound care providers actually prefer when operating under a transparent, fixed cost system. Such an approach would ensure patient access to necessary CTPs, immediately resolving the access argument. Additionally, it would eliminate the market for overpriced CTPs and curtail fraudulent billing practices.