Items
Name two "accessory" items that typically go along with a wearable on incontinence orders.
Underpads, Wipes, Barrier Cream, gloves
Give me two reasons why we coach against using multiple wearables at one time.
Skin breakdown, blocks out the strike zone of the item that is being used, causes leakage, extra bulkiness, does not actually add a layer of absorbency like one may think, etc.
Most insurances require ____ in order to receive Reusable Underpads.
Waiver benefits
What resource would I check to find item IDs for incontinence items?
Product Formulary
What date needed would you change an order to when you have verified demos/items needed with the patient?
01/01/2001
Name one qualification a patient must have in order to qualify for gloves (UHC Cap excluded)
Communicable disease or stage 3/4 breakdown
What is likely the cause of a patient leaking from the legs of their wearable?
The wearable is likely too large
What is something a patient must be doing in order to qualify for OTA wipes?
Changing the wearable at least 8 times per day
What resource do I check to verify if an order is going to need authorization or not?
What Requires Auth chart
If you see an order is in the "20- Med Docs" WIP state, what is the status of the order?
We are pending physician paperwork
What item would you recommend to a patient with very light incontinence and typically only has issues when sneezing or coughing?
Bladder control pad, male guard or pant liner
What is likely the cause of a patient leaking from the back of their wearable?
The wearable is likely too small.
A patient has Wellpoint Star Plus as their insurance and is requesting Incont supplies within the allowable amounts. Is paperwork needed?
No, orders within the allowable do not require paperwork for Cap plans.
If I verified a patient has Medicare, Texas Medicaid, and Wellpoint Star Plus listed as their insurance, where can I check to see who the payor for incontinence supplies will be?
Primary Payor Chart
If I have a patient with Driscoll Star Kids and I have sent paperwork to the Doctor, what WIP would I assign that order to?
20- Med Docs - PAR Required
What item would you recommend to a patient with severe incontinence and is bed bound?
Brief
Why is it a red flag for a patient to request underpads that exceed the quantity of wearables requested?
They are likely using the underpads by themselves.
A patient has BCBS Star kids, is over 4, and the referral was submitted by the Doctor but is missing the delivery address. Is paperwork required?
No, per the "Is PPW Needed" resource, only the Name, DOB, Items ordered, PCP signature, Diagnosis and signature date are needed. Delivery address can be obtained from the verification call.
Where can I find a breakdown of what insurances do/do not require paperwork for incontinence supplies?
Guide to MD PPW or Incont Teams page under "is paperwork needed?"
What does it mean if you come across an order assigned to "14th- Tomorrow Health" and there is no date needed?
What is the largest size of PULL UP we are able to offer without getting PS/Mgmt approval?
X-Large
A patient is calling in to request additional underpads and states they are leaking all throughout the night. They are currently in a bladder control pad. How would you approach this situation?
Open-ended question, lots of answers.
A patient with Texas Medicaid is requesting a decrease on their underpads from 120 to 60 on their template. Is paperwork required for this change?
No, decreases do not require new paperwork to be sent. The template can be updated.
Using the resources in teams, am I able to provide size 7 diapers along with an adult medium pullup?
No. Per the "Unable to Bill Together" wiki, T4526 (Med PU) and T4530 (size 7) cannot be billed together.
What needs to be verified before an order is assigned to "10si- Spanish Incont"?
Patient is Spanish-speaking only and no other English speakers in the home