SERVICE CHARGES Does WCS charge for assessments and service?

Industry information It usually takes over 5 years before a rehab technician is qualified by training and experience to assess and fit complex equipment without supervision. This is similar to the level of training required for other health care professionals. Other health care workers including therapists, nursing, physicians and aids are paid for their services and are not expected to provide any services for free. A Canadian Society of Occupational Therapists has published a minimum fee schedule guideline for private practice therapists. This could be used as a reference or bench mark to compare vendor policies for service charges.

Occupational Therapist minimum fee guidelines Professional time, including preparation, assessment, treatment, verbal and written consultation and reporting is recommended at $100 per hour; Travel time will generally be billed at half the hourly rate, but should be billed at full rate for travel time in excess of one hour roundtrip; Mileage should be billed at $0.50 per km; Flat fees may be negotiated between the therapist and client/fee payer; Program expenses will be billed at cost; Cancellation fees : –a) Therapists may charge for the scheduled or anticipated length of the visit (i.e. 1 to 2 hours) plus charge for the travel time and Mileage associated with the appointment; –b) Some practices may charge a flat rate cancellation fee ranging from $ to $500.00, depending on the number of working days notice given; –c) Cancellation fees are generally charged when less than 24 hours notice is given to the therapist but practices of individual therapists may vary; –d) No-show cancellations are generally billed at the highest rate. These minimum guidelines for Occupational Therapists are approximately double the actual rates charged by equipment vendors in Manitoba.

How can therapists obtain vendor assistance with assessments before requesting funding approval? Vendors need product specifications before we can provide pricing. Therapists often need input from the vendor to develop system specifications. Therapists may also require demo equipment to be set up to test concepts before making their final recommendations.

How can therapists obtain vendor assistance with assessments before requesting funding approval? WCS will provide one assessment service call prior to obtaining funding approval. Therapists should provide as much information as possible including an assessment report, goals, measurements and product ideas prior to the assessment to allow everyone to maximize the use of time. WCS will set up stock equipment for the initial assessment to allow the OT to verify concepts. Special order, modifications and custom work will only be provided after funding is approved. If multiple appointments are required for assessment, the funding agency must be notified and agree to consider the funding application.

Cancellation of initial assessment fee WCS will agree to cancel our initial assessment fee in most circumstances if funding is not approved. This allows a therapist to obtain our input in preparing a quotation for presentation to funding agencies prior to getting approval. The cost of the assessment will still be included in the project price if the project is approved as the assessment is an essential part of the job. WCS may cancel the initial assessment fee if ALL the following conditions apply: WCS is eligible to provide all the product or services for the project. The funding agency does not approve the project. The information provided by WCS is not used to obtain products, services or pricing from other suppliers.

WCS service fee policy WCS policy for service charges depends on the type of project and the total dollar value of the project. Different policies apply for complete systems, components and for custom work. Service charges are generally included in the product price for complete systems. Complete systems usually have enough margin in the product price to cover service costs. Service charges are shown separately for components and custom work. The margin in components is usually not sufficient to cover service costs if product pricing is discounted, so they need to be added. Custom products do not have service costs included so all service must be added.

Systems The cost of service is included in product pricing for complete wheelchair systems. Service included in product pricing is the initial assessment and fitting appointments. Standard set up and fitting are included in discounted product pricing. Modifications and custom work are charged separately.

Components The labor cost of standard installation of seating components is included in product pricing. Extra charges apply for: –Service calls –Non standard installation costs –Adjustment and fitting on other components –Set up of complete systems

Modifications and Custom Charges are based on time and materials. All service time is chargeable including –Travel –Contact time –Design –Shop labor time Service charges apply for all appointments for assessment and fitting

Modifications If the client or prescriber are requesting changes to the original specifications and the supplier needs to meet with the client for prescriber to determine the new specifications and to make the modifications, all additional service calls are chargeable. Complex wheelchair projects usually require a number of cycles of the assessment and fitting. If complete and accurate specifications could be provided in one assessment and fitting cycle, this would be the most efficient method of supplying equipment. However, if the prescriber and client are not able to provide complete and accurate specifications, the cost of the system needs to include funding to cover the cost of all service time.

FUNDING AGENCIES Each funding agency has specific rules for approving funding. Funding agencies include: –Private –Insurance: MPI, WCB, other plans –EIA [Dept of Family Services] –NIHB

General rules for funding applications Service providers must always obtain prior approval before submitting invoices for service. Complete product and pricing information must be provided. Service providers must provide sufficient justification with applications for funding.

Private & Insurance Quotation for products and services Letter of justification

Dept of Family Services / EIA SMD is designated supplier. SMD application forms must be used. EIA will consider applications from other suppliers only if SMD will not provide the required products or services. Therapist prescription for all new products and for changes to existing equipment. Letter of justification. No prescription is required for repairs. Quotation for products and services.

NIHB NIHB does not have a designated supplier. NIHB will consider applications from all qualified suppliers. No prescription is required for repairs. MD prescription, name and billing number require for new product. Frequency limits apply for new product. Detailed letter of justification required for new product. Vendor fills in NIHB application for funding.

Principles Rehab equipment suppliers rely almost exclusively on prescribers for all of our business. Suppliers need to give huge support to prescribers to allow them to do their job. Prescribers need to treat suppliers with respect.