"Managed" Care at BioConcepts REFERENCE FOR MANAGED CARE ORGANIZATIONS AND OTHERS WHO ARE INTERESTED IN OUR COMPANY POLICIES.
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info@orthotic.com (630) 986-0007 |
WELCOME We are a full service orthotic-prosthetic facility incorporated in 1992. Our mission is to deliver the highest quality orthotic-prosthetic care to the physically challenged community. We feel that providing a device is only the beginning of our relationship with a client. By providing instruction and education about the use of an orthosis or prosthesis, follow-up care to ensure that any concerns are addressed and through communication with the client, physician and other ancillary care professionals, we strive to ensure the best possible outcome for each individual client and will maintain a high standard of quality care. Our out patient care facilities located in Burr Ridge, Palos Heights and Joliet, Illinois allow us geographic flexibility in our patient care. We currently serve clients from as far away as Northwestern Indiana, Kankakee, Joliet, Aurora, and Schaumburg, Illinois as well as Chicago's south side, west side and near northside. We currently see inpatients at Loyola University Medical Center, Hinsdale Hospital, Good Samaritan Medical Center, Edward Hospital, University of Chicago Hospitals, Christ Hospital and Medical Center, Little Company of Mary Hospital, Palos Community Hospital, Silver Cross Hospital, St. Josephs Hospital, Marianjoy Rehabilitation Center, Rehabilitation Institute of Chicago and the University of Illinois Hospitals and Clinics, and many area nursing homes. BioConcepts central fabrication facility is also in Burr Ridge and allows our practitioners to have direct communication with the technical staff which ensures high quality in custom fabrication. Biomechanical and Biomedical engineers are frequently consulted to allow our staff to take the technology to its highest level. Our central fabrication not only designs and fabricates orthoses and prostheses for BioConcepts, but also contracts to fabricate orthoses for other orthotic prosthetic centers throughout the country. Volume ordering of materials and componentry for our central fabrication allows us to keep our pricing low while maintaining a high quality standard. Research and development are essential in advancing any technology based field. Our clinical staff participates in on going research projects designed to improved device function while minimizing device structure. By collaborating with several research institutions and their staff scientists, BioConcepts, inc. has been an integral part of a body of classic orthotic research projects which focus on preventing surgery with spinal orthoses. We can prevent progression of spinal deformity and injury with a spinal orthosis if it is properly fabricated and fitted in accordance with strict biomechanical guidelines. We also pride ourselves with the ability to make an orthosis or prosthesis lighter, more durable as well as more functional. We have an ongoing commitment to research and development. BioConcepts staff is available upon request to provide in-service training for any medical professionals to instruct them on the use and care of orthoses and prostheses and to teach families as well as supporting staff about care of a family member who is using an orthosis or prosthesis. We also provide managed care or other payers any information requested regarding proper selection criteria and usage of any particular device and how to get more for their prosthetic-orthotic dollar. In the current era of managed care, BioConcepts is focused on cost effective patient management. We work closely with payors to establish the lowest possible pricing, without sacrificing quality in patient care. Mission Statement It is our mission to combine immediate patient care with state of the art technology to provide maximum physical function with as minimal a device possible to help enable a high quality of life. Our clinicians always apply the latest technological advances in biomechanical research to provide the highest quality of orthotic and prosthetic care. In addition, to keep our field moving forward, we continually do research that is relevant to patient care. Topics such as quality control, biomechanics and clinical practices are discussed in staff meetings when a greater understanding is achieved.
Personalized Care Every person is an individual. Because of this, each person has different orthotic- prosthetic requirements. When someone is diagnosed with an orthopaedic or neuromuscular condition, there are many different challenges that person meets. An orthosis or prosthesis must be specific to each individual and their situation so it will meet the needs of; a) Stature. Height and weight are physical variables that strongly influence the type of device that will best serve a physically challenged individual need. Taller, heavier people require durability in their orthoses/prostheses which requires increased strength in materials. This does not necessarily mean increased bulk and weight. A smaller client may use ultra-lightweight devices that will provide optimal function yet will not need to be as 'heavy duty' as the device for the person with the larger stature. b) Biomechanical Deficit. Every disorder presents with varying levels of instability or deformity and amputations present with different functional losses. Greater losses of limb during an amputation and higher functional deficit from neurological disorders or orthopaedic injuries increase the amount of physical stress and strain a device must be able to withstand. This adversely affects the structural parameters of the device but does not necessarily require added weight and bulk. c) Ability. After a debilitating illness, amputation or injury, functioning with an orthosis or prosthesis may initially seem formidable. Upon discharge from a hospital, many clients live independently and may not have the ability to master a highly sophisticated device. Our staff provides simplicity in our devices and works closely with the physician and other allied professionals to assure that the client has enough help to enable them to rehabilitate properly with their new orthosis or prosthesis. If a family member is not available for us to instruct on the proper use and maintenance of the device, we provide verbal and written instruction for the client. If someone does not have help at home and is unable to properly use their orthosis/prosthesis without help, we communicate the need for other arrangements to be made to assist the client in the home. It is our experience that if help is not available, people tend to not wear their orthosis or prosthesis which delays rehabilitation. We frequently see the situation where a client is debilitated and unable to transport themselves to one of our offices. If this situation exists, we see the client in the home at no extra charge. We know how difficult these situations are and do our best to alleviate this burden for the debilitated client. d) Cosmesis. We provide cosmetic prosthetic and orthotic devices . Our orthoses/prostheses are streamlined so they will not draw attention to our clients condition while they ambulate in the community. There are many standard procedures we use that yield a highly cosmetic outcome without increasing cost or decreasing quality of the device. We realize that poor cosmesis may lead to noncompliance, which may be detrimental to the client. We feel that we can provide orthoses/prostheses with a highly cosmetic profile. When we see a client in our office, we always check to be sure that his or her prosthesis/orthosis is well concealed by their clothing and always maintains a high cosmetic standard. e) Cost Effectiveness. In the current era of managed healthcare we realize that the cost of a prosthesis or orthosis should be as low as possible without compromising outcome. With mounting pressures to contain costs, we offer cost effective pricing for high quality P&O devices. Cost effective patient care does not mean substandard care! By constantly striving to keep the cost of our materials and componentry to a minimum, we pass our savings on to the client. Also, with newer technology we found that superior outcomes may be achieved with less prosthetic or orthotic componentry than was required in the past, also reducing the cost. This process is called 'optimizing.' If a client is experiencing financial difficulty we will make special payment arrangements based upon each situation, alleviating some of the financial pressure associated with their physical situation. Just because someone is physically challenged does not mean that they should also be financially challenged!
Many orthoses can prevent costly surgical procedures. A well-fitted scoliosis, fracture, or back pain orthosis can prevent enormous surgical costs and several months of rehabilitation expenses. Several recent studies show that a spinal orthosis that is properly made, well-fitted, and worn by the client will reduce the likelihood of surgery for the previously mentioned conditions. Post operative spinal and limb orthoses can protect surgical procedures from failure and prevent the expense of repeat surgeries. Nonoperative and postoperative orthoses are shown to be cost effective treatments that do not carry the many risks that are inherent in other forms of treatment. Not only does our staff stay abreast of these recent "cutting edge" studies, but we frequently participate in them in collaboration with several renowned research institutions. It is our obligation to do our part in advancing the science of orthotics and prosthetics. We spend much of our free time doing research and development to improve these device's functionality while reducing costs. Our staff has developed and tested protocols for orthotic treatment of chronic low back pain, a new low-profile scoliosis orthosis, and new methods to reduce and stabilize spinal fractures with orthoses. We also have been involved in the computer modeling analysis of forces acting in scoliosis and spinal fracture orthoses. This ongoing commitment to academics assures that our staffs are leaders in the field. This means that our staff is knowledgeable about the selection fit and function of the orthoses and prostheses that they fit on a daily basis. We can answer any question regarding the care and usage of any device and are fully capable of making any modification to improve upon existing technology. Expedient turnover time is essential to allow early rehabilitation. Inpatients are all in their orthoses/prostheses within 24 hours of the time the order is placed. Most inpatients are fitted within 4 hours of the order. We understand that fitting delays are costly, so we expedite all inpatient care. Outpatients are fitted on a priority basis. Out patients are fitted immediately in the office if the prescription calls for a prefabricated 'off the shelf' type of device or garment. If they are receiving a custom fabricated device they will be fitted within one week of the first visit. Quality Assurance Program We feel that quality is essential in orthotic-prosthetic care. Maintaining a high level of quality requires several factors that we address. 1. Credentials: Our facility and practitioners are certified by the American Board for Certification in Orthotics and Prosthetics, Inc. (ABC). This guarantees that our patient facilities have been inspected by a member of the facility accreditation committee, and have met ABC's strict guidelines as being a facility that maintains appropriate patient waiting and examination rooms with the necessary equipment to measure, fit and modify any orthosis or prosthesis. Our office also must maintain high quality patient service records, and is staffed with ABC certified practitioners. Our ABC certified practitioners have attended the graduate certificate programs in orthotics and/or prosthetics at Northwestern University Medical School, Prosthetic-Orthotic Center, Completed 1 year residencies in each respective discipline and have passed the certification exam administered by ABC. This assures that a high level of clinical competence is maintained by our facility and practitioners. Complete details regarding ABC guidelines are available upon request. 2. Internal Review: BioConcepts is staffed with academically minded practitioners. We review every patient daily in a group session to be sure that, a) the most appropriate device was fitted, b) the patients' human needs are addressed c) the patient, family and respective medical staffs are satisfied with the orthosis/prosthesis quality and our service in providing the device and d) what area, if any, can we improve in the future. Not only does this ensure high quality care, this also allows us to critically evaluate each other and maintains a cohesiveness in our organization. 3. External Review: We feel that the person who is ultimately responsible for the care of the patients is the prescribing physician. Twice a year, we interview the prescribing physicians to find out if they feel that; a) the quality of our work is at, above, or below their expectations; b) our turnover time is adequate; c) patient satisfaction is at, above, or below average. We feel that the physician can give us feedback that can improve our quality on a regular basis. The physicians may point out areas that we can improve to help us better serve the community. 4. Continuing Education: Our staff is required to complete continuing education courses yearly to keep abreast of improvements in orthoses or prostheses made in other areas of the world. This assures that we maintain high quality as state of the art continues to improve. 5. Patient Survey: In our center, the patient or client comes first. We utilize a patient survey that our colleagues in other centers have helped us prepare. We learn directly from the clients about areas where we can improve . If a situation arises where a patient is dissatisfied with a particular device or with our service in general, we meet and discuss how we can correct the situation, and do so immediately. We realize that we cannot please everyone so if a situation appears to be irreparable, we refund the patient's resources and supply a list of other orthotic-prosthetic facilities in the area that they may choose from. It is our experience that negative situations, which are rare at our facility, usually arise from a lack of communication and are almost always resolvable. We feel that quality is primarily measured by others, and this is why BioConcepts, Inc. is always seeking feedback from the people we interact with on a daily basis. 1. Financial: Our financial policy is that payment of the patient's share is due upon fitting of the orthosis/prosthesis. If difficulties arise, we may be able to assist the patient in obtaining credit to pay for our services. For insurance companies, managed care organizations, and medical centers, we require payment within 60 days of the date of service. We accept Workers Compensation, Medicare assignment, Illinois Department of Public Aid, Veterans Administration and Champus in addition to private insurance, managed care carriers, health maintenance organizations, self-insured and self-pay. If overpayment is made, we send refund checks within 30 days of the overpayment. We require prior approval from IDPA, Workers Compensation carriers, insurance companies, managed care organizations, and federal carriers (VA, Champus etc.). If for any reason a patient or the prescribing physician is displeased with an orthosis or prosthesis that we have provided within 30 days of the fitting, and we cannot amend the situation in a satisfactory fashion to the patient and/or prescribing physician, we immediately refund the patient's resources and recommend another orthotic-prosthetic facility. 2. Warranty: All custom made orthoses and prostheses are guaranteed for ninety days. Off the shelf type and cloth garments are also covered for ninety days. Exceptions to this guarantee are for orthoses and/or prostheses that are abused, neglected, lost or stolen, or for excessive weight loss or gain (in excess of twenty-five pounds) yielding a loss of proper fit. Some orthoses and prostheses require interim follow-up adjustment. There is no additional charge for follow-up visits and/or adjustments unless they are for change of prescription (such as an ankle-foot orthosis being converted into a knee-ankle-foot orthosis by Doctors prescription). Failure of material, wear and tear, fatigue, cracking, breakage or loss of proper fit for reasons other than the previously mentioned reasons, are covered under our warranty. 3. Billing: Our billing is done immediately on the date of service. A friendly reminder is made every 30 days until 60 days from the date of service has been exceeded without payment. After 60 days our office manager will place a call to the responsible party to see if any payment arrangements are needed. If no reply is made to our request, our billing is automatically turned over to a collection agency after 90 days. We accept cash, check, money order, and Visa, Mastercard, Discover and American Express. A credit service for orthoses and prostheses is also available through a third party and can be arranged for at our office. BioConcepts will bill authorized payors at no extra charge to the patient. 4. Contractual Relationships: BioConcepts will negotiate pricing for a payor who is willing to make a contractual obligation. We can provide batch billing, quarterly billing, and other arrangements to ease the administrative burden of the payor. We will review and respond to any contract put forth within six weeks.
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