Patients
Why does my dressing contain silver? Isn't that expensive?
The number one cause of a non healing wound is infection and is normally commensurate with moderate to heavy drainage. Many infections today are antibiotic resistant strains of bacterium such as MRSA. In most cases, these strains have not developed a resistance to silver which sterilizes the wound bed. If left untreated, the incremental cost of an SSI is $25,546.
How long should I be on a silver product?
Most doctors prescribe silver for a 10-14 day duration. After that time, silver can become cytotoxic and begin to impede otherwise healthy cells. Everyone is different and only your doctor can make this determination.
I am off silver, but my wound is static
The second most popular cause of a non healing wound is the MMP “factory” creating enzymes which inhibit healing in otherwise healthy patients. Collagen is the most common and effective MMP controller and directs these enzymes away from the wound bed and up into the collagen layer. While most dressings only regulate moisture content (an Alginate drying a wet wound or a Hydrogel wetting a dry wound) Collagen actively interferes with the MMP process. Only your doctor can make a determination if this dressing is right for you.
What is antimicrobial gauze?
AMD roll gauze is 99.999% effective in preventing MRSA. In many cases, extended doses of antibiotics not only create antibiotic immunity, it also can dramatically impact the natural flora in your digestive system creating abdominal pains and related digestive problems. AMD gauze is nontoxic/won't impede healing.
Insurance Reimbursement - What rates do you charge?
Dressing reimbursement rates are set by the Medicare Fee Schedule and adjusted yearly or as needed by Medicare.
How can I save the Medicare program money?
By utilizing AWC’s home dressings and applying them yourself, you can save Medicare $2,500-$4,500 on average in home nursing costs.
Physicians
Simplifying Ordering Wound Care Products:
We have too much paper work
Since most chronic wounds can take at least 30-60 days to heal, Medicare allows for a 30 day / daily change of dressings for most wound products. However some physicians only order an every other day change for two weeks yielding a quantity of 7 dressings or less and two to three times the paper work/faxing/shipping/billing cost before the wound is healed.
What can we do to reduce the paperwork?
Doctors can and do write scripts for up to 90 days at a time. This allows a refill with only a fax update of the wound condition every 30 days. The dispensing order contains the absolute minimum infomation required by Medicare. Incomplete dispensing information in ANY box will require paperwork follow up on AWC and the clinic. A FULLY completed dispensing page with notes and face sheet requires no follow up.
Insurance Reimbursement When Recommending Wound Care Products to Patients:
Why can't I use multiple dressings?
In most cases, one primary dressing and one secondary dressing to secure it, is allowed by Medicare, daily for 30 days. For moderate to heavily exudating wounds you CAN add additional layers like ABD pads/AMD gauze pads for absorption provided the notes reflect this type of drainage.
Why won't Medicare allow the dressing type I want?
Medicare allows most of the premium dressing technologies available. However, it will not allow a dressing inappropriate for the wound condition, e.g. a wet wound will macerate with a Hydrogel and a dry or small drainage wound will get drier with an Alginate, hence these specific applications are not allowed. Partial thickness or stage II blisters are considered superficial and can only have gauze or AMD gauze.
Important facts about Compression Pumps when recommending for patient use
- A patient does not have to have a lot of edema. Hemositerin staining is an indication of a compromised venous system. Early treatment is essential to prevent worsening of the condition.
- Stockings are only a maintenance modality. The compression pump is a treatment modality. The two should be used in conjunction with one another.
- A compression pump helps exercise a compromised vascular system.
- Patients with Venous Insufficiency will inevitably develop secondary Lymphedema. The vascular system overflows into the lymphatic system. Again- early treatment is essential.
- A history of deep vein thrombosis (DVT) is an indication for a pump. The more venous pooling a patient has, the higher the risk for developing recurrent clots.
- Recurrent cellulitis in venous disease is related to the protein rich fluids that have third spaced into the tissue making an ideal breeding ground for bacteria. After 72 hours of antibiotic treatment for cellulitis, a pump can be safely used. The use of a pump can greatly reduce the rate of recurrence of cellulitis.
- The average hospital stay for IV treatment of cellulitis is 7-10 days, with each day incurring an expense of about $7,000. That is $49,000-$70,000 per hospitalization. Patients with recurrent cellulitis are hospitalized an average of 2-4 times annually. On the conservative end, this reflects a cost of $98,000+ annually.
- Patients who are non-compliant with stockings are often more compliant with a pump due to the simplicity of its use.
Every patient wants to know - 'How do we save the Medicare Program money?'
By utilizing AWC’s home dressings, the patient just saved the Medicare program on average $2,500-$4,500 over home health nursing costs by applying the dressings themselves.