Products
This product must be approved by a TS before sending
Spray
Specialist, compassion, service, integrity, education .
What is the 180 Way
This is a 180 Medical Authorization that can be used when we have a notice from the Dr for medical supplies.
Verbal Authorization
This team verifies insurance and sends account to New Pt team
Who is the Referral Specialist team.
This person can confirm orders.
Who is account Designee. Emergency Contact can confirm information but we cannot give them medical information.
Shows comparable items via a color-coded guide for reference on systems working together
What is a product guide
Internal messaging system alerting the proper department what documents or actions on an account are needed to further assist the client
What is a suspense
These are needed for MCD/MMC Plans to show the necessity of supplies and sometimes necessary for sending OTA
What is a Letter or Certificate of Medical Necessity (LMN or CMN)?
This suspense is used when Pt advised that new type of products are needed for existing Pt. (Catheter Pt needing Ost/ Ost needing Foley etc )
What is Ost Dual New PT (FN3640)
If a Fac calls in to give us Fax number you do this-
We can take Information, cannot give information- Transfer to: provider_facility - Internal . Note if just providing fax # can note in shell as needed.
Accessories not covered with MCR when dx is a Z93.6
What are leg-bags (A4358)?
These are all the internal departments under the one ostomy department
What are New Pt, Product Specialists, Inbound, & Outbound
this document is needed showing an examination appointment took place within 6 months by the same provider who is signing the script
What is a F2F (Face-to-Face)?
Pt calls in advising that insurance will change at end of the month order is on the 29th of the month. This suspense is used.
What is: Ost CS Rnd Robin (OS1A005). Include New Insurance info if provided, when is active, and next DOS.
This is not an automatic HIPAA violation.
What is sending order to wrong address.
Shows comparable items to send when something is discontinued or low in stock
What is the Master BO List
These are the supervisors for each individual sub-department in ostomy
Who are Jennifer Cooksey, Michael Riggs, Paulette Brown, & Briana Beasley
This document is always needed with MCD of TX to ship; but not needed for the first order when MCR is primary; however still needed by 3rd order or we cannot ship until it is on file
What is a TXIX / T19/ Title 19?
This suspense is needed when Pt has procedure changing their Ostomy (Z93.3 to Z93.2 Etc) and supplies are not changing.
What is Insurance Verification: URGENT (DS01) Specify to RS needs to go to Outbound
This is 1st contact reported to if HIPPA violation is suspected/confirmed
Who is Team Supervisor
An adapter we can rarely send due to usually not available on price list when running prof
What is a Hollister Urostomy Adapter (A9900/HOL7331)?
This STAT expectation is to be under 50% each week if possible
What is our Release Time
When Pt calls in to confirm order, and Par 6 is needed. We do this:
Can confirm order: if before 1pm CST- request Auth888 - Same Day Authorization, if after 1PM CST set order for next day shipping.
This is needed when Pt has revision/ change from Z93.3 to Z93.2 etc and supplies are changing.
What is Insurance Verification: URGENT (DS01) Specifying that New Pt is needed
IBC HIPPA violation we sent product to the wrong person. What do we do with the incorrectly received product reported.
Compliance states that we ALWAYS process return and have product picked up.. Note it is not our responsibility to advised Inde, just process the return.