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going to get yourself into trouble.
Filling and billing
Filling pumps can be both expensive and difficult, since it's necessary
to maintain the sterility of the medication. It might be tempting to just
take a couple of syringes and fill them yourself. But from a patient
safety standpoint, it needs to be done under a hood, and you need to
make sure there's no exposure to bacteria. It's not something you
want to be doing on your own. If you don't have a pharmacy in your
facility that can do it, there are pre-fill options available, but they sub-
stantially increase the cost.
Naturally, the cost of the pump is a primary consideration, along
with the complexities of billing. Some providers now offer help in this
area, too. If your billing office doesn't have experience with pain
pumps, that kind of assist can be a big plus, both from the facility's
standpoint and from the provider's standpoint.
In some cases, outpatient facilities may have to eat the cost of the
home pump, because they can't bill for it. But there's a difference
between disposable pumps and electronic pumps, according to one
company. The electronic pump might be billable to the patient's insur-
ance under the durable medical equipment (DME) line. Of course, if
you do that, you're just cost-shifting to the patient, and your orthopedic
surgeon might see a substantial increase to the patient's bill as a big
negative. On the flip side, the deductible associated with the DME is
usually much lower, and a patient who's already used crutches or other
equipment may find that the added out-of-pocket expense with the
pump isn't terribly significant.
Track record
The history of pain pumps hasn't been without challenges and unfore-
P A I N P U M P S
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