Wound, Ostomy and Continence Nurses Society Advocacy and Grassroots Toolkit (2012)
Just as wound, ostomy, and continence nursing is both an art and a science, so is advocating for the specialty and the patients we serve.
In this Toolkit, you will learn specifics from how to address a Member of Congress, to how to prepare for a meeting with one. The mechanics of Congress and your State Legislature, the titles and job descriptions of legislative staff, and the most effective ways of communicating with exactly the right people are all explained in simple, clear language.
There is an expression: "All politics are local." The importance of learning and communicating about legislative work unfolding within the all levels of government will have increasing importance as health care reform moves forward. Please carefully read and note the process for local action in your own state, and begin the conversation with your elected representatives and their staff.
Introduction to the Reimbursement Fact Sheets (2011)
In 2009 the WOCN Board developed a strategic plan for the following three years. This ambitious plan included a mandate for the National Public Policy Committee (NPPC) to develop an action plan and a section of this mandate included the following: Expand reimbursement for WOC nursing services. A task force of WOCN members from the NPPC as well as past leadership was called into action to address a work plan to meet the mandate of expanding reimbursement opportunities for WOC nursing services. A discussion of tactics as well as review of opportunities for WOC nurses to seek reimbursement was done in order to organize the work of the newly created Reimbursement Task Force. The Task Force, discussed reimbursement opportunities and road blocks. It became clear that reimbursement for some services a WOC advanced practice nurse provided was available in some settings and some locations.
Reimbursement of Advanced Practice Registered Nurse Services: A Fact Sheet (2011)
The purpose of this document is to provide the APRN with information to understand the opportunities and challenges in acquiring reimbursement for professional services.
In order for the APRN role to survive in many settings, a revenue stream may need to be developed. There are increased opportunities for billing of APRN services and it is important that APRNs understand the issues involved in capturing third party reimbursement. There are many legal and financial issues that need to be appreciated by the APRN as they relate to reimbursement. Reimbursement is a complex structure that includes regulatory factors both at the state and federal level.
While this fact sheet will cover Medicare billing regulations, many insurers will follow Medicare guidelines. However, the APRN should remember that insurers may regulate reimbursement in their own way.
WOCN Society's Support of Medicare Coverage for Enterocutaneous Fistulas Public Policy Paper (2015)
The goal of the WOCN Society's Support of Medicare Coverage for Enterocutaneous Fistulas Public Policy Paper is to provide support and evidence that supplies are necessary for treatment of fistulas, and that reimbursement for the supplies are imperative. Currently, products are only covered for fistulas that are caused or treated by a surgical procedure. This paper is stating the importance of coverage of spontaneous fistulas, as that is not currently covered by CMS.
Understanding Medicare Part B Incident to Billing: A Fact Sheet (2011)
The purpose of this document is to understand the issues involved in Medicare Part B "incident to" billing that may be considered for use in billing wound, ostomy, and continence nursing services in the out patient setting.
"Incident to" refers to a Medicare billing mechanism, allowing services furnished in an outpatient setting to be provided by auxiliary personnel and billed under the provider's national provider identification (NPI) number. "Incident to" the provider's professional services means that the services or supplies are furnished as an integral, although incidental, part of the provider’s professional services in the course of diagnosis or treatment of an injury or illness (Medicare Benefit Policy Manual, 2011).