Prescriptions
2L continous with an M tank?
HTF
What is an ONO and for what set up?
ONO= Overnight Oximetry
NOC O2 w/out OSA
Apria pt is only showing a 246 billing and now they need to add portability, how would we run this?
Initial and answer NO to same sim
Medicare and the patient lives in CO
*PT51, Jurisdiction C
What tool do you use to make sure you have the correct equipment?
SPG-Standard Product Guide
7L PRN
DX:G44.009
Cluster set up: 560/076
What qualifies with no extra testing?
88% or less on RA at rest
Same/Sim showing history w/Apria for E1390/E0431 and now they are wanting a POC, how would we input this?
Change in RX/Modality change and answer YES to same sim.
Humana Advantage PPO Plan.
Pt lives in CA
*HU41-HUMANA PPO MEDICARE ADV
What tool do you use to select the correct insurance?
PD
Pt needs .5-3LPM?
246/508-HTF w/a Flow Meter/reducer
A pt is being D/C on 5/4/26 and the testing we received was done 4/30/26, can we accept this? Why or why not?
HDC's MUST be w/in 2 days of discharge. This test will be 4 days old. Cannot accept.
Same/Sim showing pt had a 246/508 with a last bill date of 2/26/2026 and now they are needing a 246/086. How would we process this?
Initial and answer Yes to same/sim and a break in billing of 60+ days
Alignment, Advantage Plan
Allcare IPA, County: Stanislaus, CA
#ALC54-ALLCARE IPA-ALIGNMENT HP DUAL
What tool do you use to answer question for insurance?
AQG
Pt was tested on RA and their SPO2 was 95%, however they do need O2 for 2HRS a day, can we process this?
Yes, they need a cluster set up. 560/086
The pt is needing 6LPM continous, what do we need for their testing?
We will need high flow testing on 4L or higher.
Pt has E1392/E1390 showing billing with SuperCare, last bill date was 4/25/26 and they are wanting a POC from us. 15 months paid.
Transition Provider and YES to same/sim.
JQE12345, pt lives in CA and has Medi-Cal
#BC76-ANTHEM CA-MDCL-NON MG ONLY
Where do you check for prescription information?
PPI
PT needs an E tank w/a pulse dose conserving regulator, what is their set up?
246/221-Standard w/OCD
If a pt needs NOC w/bleed in what do we need?
We need a PSG-polysomnogram, showing AHI reducing to 10 or less on optimal setting and their O2 is 88% or less.
Same/Sim shows Initial date is over 5 years from current provider. How would we input this?
Bonus 50 pts-could we process this?
Replacement over 5 yrs, this goes to the Re-OX team/BRC.
We could only process the order if the O2 CTS
LKQ12345, SR pt lives in CA
Bonus 50pts-where does claims go to?
#BBI00-BCBS IL MCR/BS CA MCR
Blue Shield of California
How do you look up a HCPC?
ESC, 5, 2, 15