Why Your Brace May Cost Less Online
We understand that the pricing of medical products can be a confusing and frustrating experience for patients. Sometimes patients are surprised to find they are billed more for a product they can find online at a lower cost.
Breg has provided high quality medical devices to patients for more than 25 years. We are a longstanding accredited Medicare supplier and are contracted with hundreds of private insurance carriers. Whether billing Medicare or private insurance companies, Breg is held to a strict set of standards that govern how we bill patients for coinsurance or deductible responsibilities. Our pricing is established from product codes and rates that are set by the federal government or are negotiated with insurance providers, and used throughout the industry as a standard practice.
When a healthcare provider (HCP) prescribes a Breg product, the patient is first medically assessed to determine the best brace for his/her condition or injury. As a general rule, the patient’s prescribed brace should be fit by a professional followed by instructions on the proper use and care of the device. Some products are more complex than others, and the amount of service required is at the discretion of the HCP.
In addition to an HCP’s office, many bracing products are prescribed in an acute care setting, such as in an emergency room or urgent care facility. By having access to Breg products while at an HCP’s office or in an acute care setting, the patient can take the item from the provider, use it immediately, and leave the office or acute care facility better protected from further injury. When ordering online, the patient selects and buys the product, then waits for it to arrive. If the wrong product arrives or it does not fit, the patient must return the item and wait for a replacement while the injury or condition goes untreated. This immediate availability of product is a benefit that is not offered by purchasing the item online and then waiting to receive it.
After receiving the product and signing our Patient Acknowledgement Form, Breg collects information required by the insurance plan or Medicare to submit a claim on behalf of the patient. It can be weeks or in some cases months before the insurance company or Medicare reviews the claim and responds to Breg. After we receive a response, we may then bill the policy holder or Medicare recipient according to the individual plan responsibilities related to deductibles and coinsurance. As a result, there are significant costs associated with insurance billing services. In contrast, when buying a product online there is no professional fitting or instruction for the brace, there are no insurance billing services available and nothing goes toward satisfying deductibles or coinsurance.
In summary, items purchased online do not contain any of the billing, service or supply costs mentioned above which is why online pricing can be, and typically is, much lower. We openly disclose estimated product prices on the back of the pink copy of the Patient Acknowledgement Form that is provided to the patient. Additionally, patients have every right to choose not to receive the product at the acute care setting or HCP’s office but instead find it on their own.
We work hard to provide our healthcare provider customers and patients with a positive, remarkably easy experience and apologize for any confusion. Often, posts on social media pages for medical supplies are negative because of the perceived pricing disparity. What is not shown are the thousands of patients satisfied by the products and insurance billing services we provide.
We are always happy to talk with patients about their specific cases. Because of patient privacy laws, we cannot discuss patient situations in an open forum like social media. We invite you to call our Breg Billing Services team (Omni Motion) to discuss your claim at 855-358-7405.