What medical supplies are you paying out of pocket that your insurance company already covers?

My name is Kim and I'm the Administrator at Americle Healthcare, Inc. I have been with the company for 5 years and have extensive knowledge of the medical supply and equipment industry. About a year before I started with the company, both of my grandparents on my dad's side of the family were not doing well and passed away later that year. Looking back, I realized that they had paid out of pocket for lots of supplies and equipment that would have been covered through their health insurance. If I knew what I know now, I could have saved them stress, time and money. I still get phone calls daily from patients and take the time to listen to their concerns and help them out by informing them about what supplies can be covered so are not surprised with a bill later. A lot of companies do not go after the necessary paperwork or authorizations to get items covered for individuals, but at Americle we do. We take the extra step and make our customers extremely happy for getting items covered. Just the other week, I had a patient who needed items for her husband and she had already been buying them out of pocket for a few months because was told that they weren't covered. I informed her that I was almost sure that they would be covered. She told me to go ahead with the authorization and that she appreciated the effort but did not believe that it would be covered. Two days later, I got word back from her insurance that the items were covered at 100% and they sent me an authorization for it. She was ecstatic and couldn't believe it. It was such a great feeling to help her out. So if you're looking for a company that goes out of their way for their clients or if you are looking to get some of your questions answered, give us a call. I get calls from nurses that some guidance on what to do in order to get something covered. I am always happy to give them my advice and help them out. We also offer exceptional competitive pricing for medical supplies and equipment.  

If you have any questions regarding what’s covered and what’s not, would like out of pocket pricing or free samples, please give us a call today or e-mail Kim at [email protected]. Happy Thanksgiving!

As our parents and loved ones grow older, we fear our pockets and extra savings are growing slimmer

A survey claims monetary cost as the biggest concern for the future caregivers of America. According to an online survey conducted earlier this month by Harris Interactive for Amedisys, a leading provider of home health care and hospice services, one-third of Americans do not feel they will be financially prepared to care for their loved ones once that time comes.

Other concerns listed were lack of expertise about diseases and not having the amount of time that taking care for a person at home requires. 

Some 44 million Americans provide care for an aging relative at home at any given time and costs can average up to $6,000 per year. Needless to say, this issue concerns people across the entire socio-economic spectrum.

However, it is possible for some caregivers to receive a small, but regular payment for their work and commitment. If the person you are caring for is eligible for Medicaid, you may be able to receive direct payments in the states that run the Cash and Counseling Program. Other states have similar programs for low-income seniors and long-term care insurance that includes in-home care coverage, can be used to pay you.

But how can you avoid unnecessary costs? Inform yourself.

Medicare and other private insurers advise seniors to rent home medical equipment when in the long run, buying it could save you a significant amount. Let’s take a closer look at oxygen concentrators. They are used by patients who have trouble breathing, and renting one may cause you to, after three years, pay double the cost of buying the item.

However, many rental companies claim their prices also include certain services. Not everyone knows how to work the machines properly and some rental companies provide Respiratory therapists should you need assistance, as part of their package. 

Do you know of any other ways future or current caregivers can save some money? 

Although this video comes off as humorous, there is a morsel of truth: these are real consequences of what could happen to home medical equipment companies, like Americle, if they don’t don’t have the right documentation. Companies could be audited and if they don’t have everything the RAC auditors are looking for, they will recoup the money and the company could be fined. This documentation process may be annoying to patients and doctor offices, but companies could go out of business due to fines and penalties. We hate asking our customers to go through this tedious process because we care so much for them and just want to serve their needs. Unfortunately, our hands are tied.

“Home care is a combination of compassion and efficiency. It is less expensive than institutional care… but at the same time it is a more caring, human, intimate experience, and therefore it has a greater human element… it’s a big mistake not to try to maximize it and find ways to give people the home care option over either nursing homes, hospitals, or other institutions.”

Former Speaker of the House Newt Gingrich

This video points out the ridiculousness of the new competitive bidding system for home medical equipment from Medicare.

This is just one story about a customer suffering because of Medicare's new competitive bidding system.

Medicare Eliminating Your Choice in HME Provider

While competitive bidding for the HME industry is not a new concept, the fact that it will be kicking into high gear next year has many people worried. If you're not aware, Medicare is required by an act of Congress to replace the current fee schedule payment methodology for selected HME items with a competitive bid process. Competitive bidding allows Medicare to award contracts for particular items or services to suppliers that submit low bids. Despite extreme opposition to this plan by the industry, economists, and patients, Congress continues to propose competitive bidding in some form.

Here are some of the major problems with this new system:

It limits access to necessary products and services. Right now, suppliers provide a broad selection of items and essential services, such as repairs. But since competitive bidding is based on the lowest bid, suppliers may need to cut back on services and products to keep their bid low.

It eliminates choice for the consumer. Although a beneficiary may have a longstanding relationship with a supplier, competitive bidding would force them to get their products from a supplier chosen by the federal government.

It will discourage product innovation. Because the contracts are based on low bids, suppliers will be unwilling to adopt new technologies that improve quality of life, but raise up-front costs. They may even resort to cheaper products. This rewards those with cheapest products, instead of those with higher quality ones.

It will hurt small businesses. Many HME companies are small businesses that have been supporting their customers for many years. This hurts not only that business, but the community. It also means that there will be less bidders when it's time to renew the bidding process. Bid prices will likely rise and patient choice will diminish.

In the current economic climate, it makes no sense to enact an already broken and confusing system that eliminates consumer choice and destroys small businesses.

Have you had experience with this new system? What do you think about it?

November is National Caregiving Month! In honor of that, here are some interesting statistics about the profile of a caregiver.

Most Americans will be informal caregivers at some point during their lives. During any given year, there are more than 44 million Americans (21% of the adult population) who provide unpaid care to an elderly or disable person 18 years or older.

Altogether, informal caregivers provide 80% of the long-term care in the Untied States.

61 % of caregivers are women

Most caregivers are middle-aged.

13 % of caregivers are 65 years old and older.

59% of informal caregivers have jobs in addition to caring for another person. Because of time spent caregiving, more than half of employe women caregivers have made changes at work, such as going in late, leaving early, or working fewer hours.

Sleep Hygiene: Tips for getting a good night's sleep

What determines a good nights sleep differs from one individual to another. Trying a variety of things may help in finding the best routine for the perfect nights sleep.

Ten sleep hygiene rules to consider:

Cut down on your "bed" time. Spending a lot of time in your bed prior to your regular sleep periods can make your sleep more shallow. Find a different location to do activities such as reading or watching TV other than your bed.

Maintain a regular bedtime. Waking up too early or sleeping past the time you need to get up are clues that you might need to adjust your bedtime. Keeping a regular bedtime every night allows you to get enough rest before rising.

Avoid a clock in your bedroom. It's OK to set an alarm but put it in a place where you can`t see the time on the clock. This will eliminate any pressure that clock watching may cause during the night.

Exercise:  Getting regular exercise will help you sleep better at night. It is best to do this three to six hours prior to bedtime.

Avoid trying to get to sleep. The more you try the more awake you become. If you are having difficulty falling asleep, get up and watch TV or read for a while until you naturally become drowsy.

Eat a light snack. Try drinking a glass of milk, cheese and crackers or any other light snack might help.

Avoid caffeine. Try avoiding all coffee and beverages containing caffeine, such as colas from lunchtime on. You may want to try avoided tea and chocolate as well if you are very sensitive.

Deal with worries prior to bedtime.  If you are worry-prone, take a half-hour earlier in the evening for some alone time. Write down what worries you and think about potential solutions to problems you are facing. Set them aside at bedtime.

Try taking a hot bath at bedtime. Spend some time in the tub relaxing often helps you sleep more soundly.

Try adjusting your bedroom environment. Do whatever makes you more comfortable such as using heavy drapes to make the bedroom darker, Opening a window for some fresh air, or drowning out noise with a fan. Find out what works best for you.

What do you do when you're having problems sleeping?

If employees spent less time worrying about their loved one at home, would they be more productive at work? Absolutely. For those employees who serve as caregivers to their elderly parents or perhaps a disable child, peace of mind while they’re working is a huge relief—and we often work with families to provide respite care solutions they can depend on. A research study done by the National Alliance for Caregiving and Center for Productive Aging from Towson University found that working caregivers spent a substantial amount of time away from the office to fulfill their care duties at home. In fact, it was reported that: * 81% of caregivers routinely took time during the workday to make arrangements for care or to check on their loved one. * 70% said they needed days off to attend to their caregiving duties. * 64% arrived late or left work early. * 41% took time at work to discuss caregiver issues with co-workers. Today, more and more employers are adding eldercare benefits to keep employees healthy, both mentally and physically. Before an emergency arises, it’s important to ask employers what benefits and resources are available from the company during these times of need.

Family Caregivers in the Workplace | Aaging Better

A very interesting blog post from AAging Better

10 Tips for Family Caregivers

On Monday, the New York Times published a blog about the hidden benefits of caregiving. The study showed that while caregivers do have more stress, they have a lower mortality rate, performed significantly better on memory tests, and maintained stronger physical performance than non-caregivers. This was a shock to the researchers who believed that caregiving was stressful and physical draining to individuals.

So for current caregivers or those thinking about becoming one, here are some helpful tips:

Caregiving is a job and respite is your earned right. Reward yourself with respite breaks often.

Watch out for signs of depression, and don’t delay in getting professional help when you need it.

When people offer to help, accept the offer and suggest specific things that they can do.

Educate yourself about your loved one’s condition and how to communicate effectively with doctors.

There’s a difference between caring and doing. Be open to technologies and ideas that promote your loved one’s independence.

Trust your instincts. Most of the time they’ll lead you in the right direction.

Caregivers often do a lot of lifting, pushing, and pulling. Be good to your back.

Grieve for your losses, and then allow yourself to dream new dreams.

Seek support from other caregivers. There is great strength in knowing you are not alone.

Stand up for your rights as a caregiver and a citizen.

What advice would you offer a caregiver?

There's No Place Like Home

A 2006 study by the American Association of Retired Persons found that 89 percent of respondents wanted to stay in their own homes as long as possible. Of course, who wouldn't want to stay in a familiar place where they have created so many memories? But over time, this beloved sanctuary may begin to show its years, as are you. On a bad day, climbing the stairs may seem like scaling Mount Everest. Carrying a laundry basket down the basement is a balancing act, and the thought of lugging it up two floors to make the beds is cause to sit down and rest.

That "little fall" in the bathroom last year left your hip and ego bruised, but it was alarming enough that your children became concerned about your ability to stay safe and independent at home. Before putting up the "For Sale" sign in the front yard, consider some small changes that you can make that will allow your loved ones to stay in their home.

Some involve simple changes that might make you say, "Why didn't I think of that?" Others involve assistive devices and aids to daily living that can make everyday tasks much easier and safer. On yet another level, home modifications can literally create new, safe spaces within your home.

Each situation that calls for home medical equipment is unique. Surgery, long and short-term disability, mobility limitations, respiratory disease, aging parents who want to stay in their homes, children with disabilities or medical conditions – each presents its own set of challenges.

To find specific steps you can take to modify for you home, see our Home Modification Guide here. This guide is intended to help you stay in your own home as long as you wish and on your own terms. It contains useful information about ways to help you get around in your community. We can help you make informed decisions about assistive equipment, and home modifications that can be the difference between staying independently in your home and alternatives that are not nearly as desirable.

'What makes a company compassionate and driven to help others does not necessarily come from any physical circumstance of someone close to them. A company’s compassion is derived from those who work there. An owner can influence the staff to a large degree but the SENSE OF URGENCY must come from the heart of all that work there. Every single person that works at Americle Healthcare, Inc. is driven to help others by a SENSE OF URGENCY of their own accord.”

Jon W. Parlett and Matt Seddon, owners of Americle