Compliance
Billing for services that were never provided is an example of this.
Fraud
True or false: We need a prescription for ELR's/ALR's?
True
How many liters of Oxygen does a patient need to be on to get an o2 mask?
at least 5 or higher
What are the 4 parts of Medicare and what does each cover?
Medicare A Hospital
Medicare B Visits and DME
Medicare C Advantage replacement
Medicare D drug plan
What item do ALL Adapt employees need with they at all time?
Name badges
This occurs when services are overused or billed unnecessarily, increasing costs without improving care.
Waste
How are trainings conducted?
VGM's and Adapt Uni
If a patient receives Oxygen from us now wants a POC, what do we need to bill insurance, and what steps do we take to get them set up?
We need a valid RX and a walk test in office within 90 days of home setup. Unless pt is on 1 lpm
A supplier obtain BLANK from a state-licensed oxygen supplier.
Oxygen
This type of information includes names, medical records, and insurance details.
What is Protected Health Information (PHI)
Offering something of value to influence the referral of Medicare business may violate this law.
Anti-Kickback Statute
How long is a prescription for a nebulizer valid for?
1 year but notes must be within 30 days of prescription
True or False: We do not need a prescription for a humidifier bottle?
False. We still need a prescription.
A supplier must notify beneficiaries of Blank coverage and honor all Blank under applicable State law
Warranty
This acronym refers to the law that protects patient health information.
HIPAA (Health Insurance Portability and Accountability Act)?
Submitting false claims for payment to Medicare violates this federal law.
False Claims Act
Patient who has Synapse insurance is getting setup with a hospital bed. When do we collect Autopay?
We do not
What is our backup method when we setup the patients with Oxygen?
Tank and at least 24 hours worth
A supplier must maintain a physical facility on an appropriate site of BLANK.
at least 200 square feet
Name 3 Medicare DMEPOS Supplier Standards
Patient have the right to choose provider
Hours of Operation must be listed on front door
Patient has the rights to refuse service
______ Is the guidelines we must follow to bill Medicare.
Medicare DMEPOS Supplier Standards
True or false: If a patient with Medicaid does not qualify for an item. We can offer OOP pricing and classify the order as retail.
False. We are not able to charge Medicaid patient's
What is the proper way we instruct patient's to store their oxygen tanks?
Oxygen tanks should always be stored upright and secured to prevent tipping or rolling.
DMEPOS suppliers must remain open to the public for a minimum of BLANK per week with certain exceptions.
30 hours
Where can you find the Medicare DMEPOS Supplier Standards?
Policy Stat