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Deductible Renewals & Updates

Insurance PaperworkDeductible Renewals:
With 2014 nearing, we wanted to take this opportunity to address an important insurance issue that a new calendar year always brings. Whether you have an individual or employer-sponsored Health Insurance plan, there are certain things to keep in mind as we close out 2013.

There are many qualifications and limitations regarding what health insurance covers and to what extent. Certain requirements must be satisfied before the insurance company will begin paying benefits. A deductible is a fixed dollar amount the policy holder must pay out-of-pocket for eligible services before the insurance company will make payment on covered medical expenses. [For example, if your policy has a $500.00 deductible, you must pay $500.00 worth of healthcare expenses before your insurance will start paying out.]

For most policies, the medical plan’s deductible is based on a calendar year regardless of when your coverage became effective. All calendar year deductibles will therefore be renewed on January 1, 2014. If you are unsure about your policy, please contact your insurance carrier for more information.

Update Your Information:
We're dedicated to providing the highest quality products, equipment, and services to our customers. In order to do so, we rely not only on our tremendous staff, but also on the very patients that we service. It's extremely important that you keep your account with us updated.

Insurance Policy: It’s always a good idea to keep yourself as informed as possible when it comes to your insurance policy. It’s just as important to keep our office up-to-date on any changes that may take place. Many insurance policies renew, change, or terminate at the end of the year. This could mean changes in your financial responsibility as it relates to our products and services.

Contact Information: The quality of our service also relies on being able to communicate with our customers. Any change in your address or phone number (temporary or permanent) should be reported to our office as soon as possible to avoid potential issues with deliveries, billing, etc.

Payment Information: Please keep our Billing Office notified of any changes in your billing information. This includes billing address changes, new debit/credit card information (new card number, expiration date and/or security code), and new bank information.

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Pulmonary Rehab & COPD

Stretching Exercise Pulmonary RehabFormal pulmonary rehabilitation programs have been in existence since the mid-1990s, but a rudimentary form was used to treat tuberculosis as far back as the 1880s. Over the years, diagnostic tools and intervention methods have been refined and the therapy has expanded its use to a wide range of respiratory conditions from chronic obstructive pulmonary disease (COPD) to cystic fibrosis (CF) and many others in between.

For the most part, traditional pulmonary rehab programs serve the same patient population and follow a similar treatment protocol. Richard Novitch, MD, pulmonary rehabilitation director and director of the pulmonary function laboratory and blood gas laboratory at Burke Rehabilitation Hospital in White Plains, New York, explained that the treatment is directed toward patients suffering from a reduction in quality of life due to COPD or other lung diseases. "It's a way to help people develop coping strategies with the limitations of life activities," he said. "Regardless of age and underlying diagnosis, the quality of life issues are the same."

Shortness of breath often prompts a referral from a pulmonologist, internist, or primary care physician. Patients sometimes ask to self-enroll; however, in order to comply with Medicare guidelines, which drive pulmonary rehab protocols, the patient must have a physician referral.

Medicare Part B may cover the cost of pulmonary rehab if certain conditions are met. The patient must have a diagnosis of moderate to very severe COPD (validated by pulmonary function tests), and must be documented to meet Medicare's GOLD Classification II, III, or IV. Medicare also requires all pulmonary rehab programs to include physician-prescribed exercise, education, and training customized to each patient, along with psychosocial and outcome assessments. Moreover, the exercise plan must designate mode, target intensity, duration of each session, and frequency.

The physician must review the treatment plan every 30 days. A total of 36 visits are allowed with an additional 36 upon receipt of a letter recommending more rehabilitation. Other insurers may cover pulmonary rehab, and many often follow Medicare's protocol requirements.

Risks in pulmonary rehab programs are virtually nonexistent, said Novitch. "Patients exercise to tolerance of risk. The lungs act as governor on an engine. If the patients are sick, they don't show up. Also, Medicare guidelines require a doctor to be within walking distance- 300 feet- of a program," Novitch noted, adding that other clinical professionals are in attendance at all times.

To keep reading the full article, click here to visit RT Magazine online.

Pro2 LLC Oxygen CPAP Buffalo NY

Hanlon, Phyllis. (2013, October 14). Pulmonary Rehab: Expanding Its Clinical Impact. [Web log post]. Retrieved November 21, 2013, from http://www.rtmagazine.com/clinical/19206-pulmonary-rehab-expanding-its-clinical-impact.

The Holidays & Oxygen Use

Family Time with Oxygen Pro2 LLCThe holidays are approaching quickly. Here are some things to keep in mind for our oxygen patients and their loved ones.

Hydration & Moisture
Be sure to keep yourself hydrated. The best thing for helping to move mucus is to drink plenty of water. And as the furnace kicks on more, be sure to monitor yourself and not let your nasal passages dry out. This could cause a nose bleed.

Patients using blood thinners may require extra humidification at this time of year. First, start with an over-the-counter saline mist to use several times per day. Next, add a room humidifier to moisten the air. If you try these and you're still dry, call us so we can set up a humidifier directly to your oxygen concentrator. These humidifiers require some education but they will definitely help when all else has failed.

Safety
Our first goal is always safety. When oxygen is used not all of the oxygen goes in to your respiratory cavity; it also gently spills out onto your clothes, hair, chair, bedding, etc. making you and your immediate surroundings easier to start on fire.

Oxygen does not combust, but it does make something burn better. So please do not stand near a fireplace or put tubing or equipment within 10 feet of a space heater, fireplace, or even a candle. And absolutely no smoking with oxygen in use! Remember that you and your loved ones burn better while using oxygen.

Travel
If you’re traveling this holiday season to be with family, friends, and loved ones, call us to help with arrangements or answer any questions you may have. Remember that the airlines now require letters signed by your primary care physician stating the need for oxygen in order to travel with it.

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How to Make Your Home Safe for Medical Care

Eldery Man in the homeAt Pro2, we want to make sure that your home medical treatment is done conveniently and safely. Many of our client/patients are limited in strength or unsteady on their feet. Some are wheelchair or bed-bound. Here are some some easy and helpful tips on how to make the home safe for home care.

Fire Safety and Prevention:
- Smoke detectors should be installed in your home. Make sure to check the batteries at least once a year.
- If appropriate, you may consider carbon monoxide detectors as well. Ask your local fire department if you should have one in your home.
- Have a fire extinguisher in your home and have it tested regularly to make sure it is still charged and in working order.
- Have a plan for escape in the event of a fire. Discuss this plan with your family.
- If you use oxygen in your home, make sure you understand the hazards of smoking near oxygen. Review the precautions. If you aren't sure, ask your oxygen provider what they are.
- If you are using electrical medical equipment, make sure to review the instruction sheets for that equipment. Read the section on electrical safety.

Electrical Safety:
- Make sure that all medical equipment is plugged into a properly grounded electrical outlet.
- If you have to use a three-prong adapter, make sure it is properly installed by attaching the ground wire to the plug outlet screw.
- Use only good quality outlet extenders or power strips with internal circuit breakers. Don't use cheap extension cords.

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Competitive Bidding Complaints Continue

Since June 18, 2013, People for Quality Care (PQC) has collected information from beneficiaries about their experiences with the Medicare Competitive Bidding Program to better understand the impact of the program on the health and well-being of senior citizens and people with disabilities.

The Medicare Beneficiary Complaint Hotline was established out of concern that beneficiary issues caused by the competitive bidding program were not being properly reported to the public or the important decision makers who can make a difference. While CMS reports just over 30 unresolved complaints, PQC information varies greatly from that report.

Below is a snapshot of the information they gathered from frustrated medical equipment users throughout the country. This information is shared with Congress regularly.

1888 Complaints Received As of Sept 5, 2013
- 37% of calls are general frustration about losing access to a provider of choice
- 63% of calls relate to a specific problem resulting from the program that inhibits access to medical equipment and service
- 67% of callers choose to be transferred to the congressional switchboard
- Busiest week (7/29/13) = 54 complaints per day
- Average weekday since July 1 = 44 complaints per day

Each call is organized into one of 16 issue categories. The top five issues include:
1. Change of provider, including was happy with old provider and quality of care received, old provider was local to the area, being denied rights and choice, don't deserve this treatment after contributing to Medicare for so many years
2. Difficulty receiving supplies/repairs
3. Difficulty finding a new provider
4. Increased cost to beneficiary
5. Product of choice is now unavailable

Competitive Bidding Complaints by State

States with more than 100 beneficiary complaints include New York, Florida, California, Illinois, and Texas. Complaints have been received from 45 different states, Puerto Rico, and the District of Columbia.

If you or a loved one relies on home care, chances are you understand the role of a medical equipment provider in your life. Millions of oxygen users, wheelchair users, and those who rely on a feeding tube understand that not having a reliable provider available to you greatly impacts your quality of life.

For those who do not understand this, including some Congressional members, we must work to educate them in order to prevent detrimental programs such as the Medicare Competitive Bidding Program and others from threatening patient quality of life.

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