Medicare/Medicaid
How often will Medicaid cover DME equipment?
3 yrs
Who is responsible for monitoring AdaptHealth's reporting mechanisms for compliance or ethics concerns?
Chief Compliance Officer
Where do we record walk test results?
Clinical tab and under the Oxygen tab.
Per Compliance how are we supposed to answer and close the phone calls?
Too much to type
Medicare PAP patient got their machine in July but is not having issues with it. How do we take care of them?
TRUE OR FALSE
Bribes or kickbacks of any kind for services that are paid under a Federal health care program (which includes Medicare) constitute fraud by the person making as well as the person receiving them.
TRUE
Which of the following is NOT an example of an ethical issue to be reported?
A. Violation of confidentiality policies
B. Patient does not like employee uniforms
C. Falsifying documents
D. Inappropriate behavior of staff members in the home
B Patient does not like employee uniforms
How often are patients able to fill tank orders?
Once a week and no same day delivery unless approved by management.
When is a Home Safety Assessment completed?
At the time of setup with any equipment.
BCBS patient is wanting to get 3 months worth of cushions. Are they able to?
They are but it must be explained to them that BCBS will only bill one cushion per month even though they were received at the same time.
What is the verbiage to qualify for a transport chair?
1. Must rule out the use of a cane and walker
2. Patient is NOT able to self-propel but a caregiver can push them
3. Patient's mobility limitation impairs ability to participate in one or more activities
TRUE OR FALSE
The company’s Code of Ethics and Business Conduct applies to full-time and part-time employees, directors, officers, and contractors.
TRUE
If we receive an order that shows their SATS drop to 89% do they qualify?
The patient would qualify for Group II which would be short term Oxygen and then would have to requalify in 2 to 3 months
Where can TB information be found?
Break room.
A Luna patient comes into the store stating they are having an issue with their machine. How do we take care of the patient?
Try to trouble shoot and if it nothing we can figure out we swap out their machine.
What are some of the penalties for violating fraud, waste, and abuse (FWA) laws?
A. Civil monetary penalties
B. Imprisonment
C. Exclusion from participation in all Federal health care programs
D. All the above
D. All the above
How often are we supposed to complete Compliance Training after being hired?
At least annually
Patient calls in needing tanks but does not show they are renting Oxygen. How is this handled?
We must inform the patient that we need new documentation to start billing their insurance again. Check with Management if tanks can be sent out.
What trainings have you had regarding infection control?
Competency testing and VGMS
What is the difference between a BiPAP and a CPAP?
BiPAP works with your breathing both when you inhale and when you exhale.
CPAP pushes the constant pressure into your body whether you're inhaling or exhaling.
Dr is ordering a patient a shower chair. How do we check if they are PECOS certified?
You would need to go to the Medicaid website and do a Practitioner search with their NPI.
https://www.nctracks.nc.gov/publicPortal/provider/loadPractitionerSearch.action
AdaptHealth Policy Conflict of __________ and Disclosure describes in detail all the employee expectations as related to personal conflict of interest.
Interest
If a patient calls in with an issue with their concentrator, what steps do we take to service them?
How do you access company policies?
Central Portal under Corporate Compliance/Policies and Procedures.
Patient is at the hospital and being ordered a PAP machine. How do we process this?
We do not. If it is intended to go through insurance, it would have to go through PAP Intake.