Meds
True or false- we can cover the copay of a patient's antibiotic for DC.
False! We can't cover any copays or coinsurance.
A patient needs a FWW for DC home. He has FES only. He says his brother could order him one from Amazon, but he won't be able to bring it before this evening. Can we give him a charity FWW?
No- he has an alternative source for the DME needed. We would not provide a FWW.
An uninsured patient needs home PT for family training on new DME and safe transfers. Can we Banner fund this?
Yes! We can Banner fund home PT visits to transition a patient to home if they don't have insurance. The other requirements still apply- they need an address and physician to follow.
A patient with AHCCCS needs transportation home to Scottsdale. After multiple attempts, no one from the transport company has picked him up- can we do a Lyft?
Yes- if we have tried to use a transport benefit without success we can use a Lyft within the local area.
A patient states someone told him his medications would be paid for since he doesn't have insurance. He is able to afford the cost of the medications, but refuses to pay. Can we Banner fund for DC?
No- he is able to afford the medications, but refuses to pay.
True or false- we only need to complete the ad-hoc Cerner form for Banner funded wheelchairs.
False! This exceeds the $150 cutoff for the ad-hoc form. The long form must be used.
No- this would exceed a small number of visits and would not have an "end date". The patient/family would need to be taught the wound care prior to DC.
A patient with bilateral AKA is ready for DC back to his home. His wheelchair is broken (received 2 years ago) and he needs a new one for DC. Can we Banner fund a new one?
No- he would need to contact the supplier for a replacement or repair.
A trauma patient is DC home and needs oxycodone for pain. He does not have insurance. Can we cover the $10 copay?
No- we cannot cover the cost of narcotics.
A patient is unable to afford self-pay for oxygen but is unable to discharge without it. Can we cover this cost for 30 days?
No- oxygen equipment is considered rental equipment and is needed long term.
An uninsured patient with traumatic injuries is unable to return home as his wife is physically unable to care for him. He has good rehab potential but is medically cleared. Can we do a Banner funded SNF?
Yes, as long as the patient has a long term plan and there is documentation that a short SNF stay would transition the patient to home.
A patient with Medicare A/B wants to go to a SNF in Flagstaff. The SNF will not cover transport and the patient can't afford the cost of transport. Can we cover this cost?
No- We cannot Banner fund transport out of area when there are SNFs in this area that can accept the patient. The patient would have to cover the cost or stay locally after DC.
A patient has Medicare A and B but his D plan is new and won't take effect for 30 days. Can we cover the cost of his blood pressure medication, aspirin, and oxycodone?
Yes- we can cover the BP med as long as there is documentation of a long term plan to obtain refills. Aspirin is over the counter and oxycodone is a narcotic, so we cannot cover those.
An uninsured patient needs a Lifevest for DC due to an EF of 10%. He can't afford the deposit for the vest. Can we cover the deposit?
No- We cannot cover the cost of any type of rental equipment.
A patient with a history of IVDU needs 2 weeks of IV abx. He does not have insurance. He is refusing a SNF but agreeable to HH visits since he lives with family. HH is much cheaper than a SNF- can we Banner fund HH?
No- trick question! He has a history of IVDU, so cannot Banner fund HH. We would need to look at a SNF. If he refuses a Banner funded SNF to complete treatment, he would need to sign out AMA.
What is limit for Banner funding without leadership approval?
$150 for DME, $100 for medication
An uninsured patient on a combination of anti-infectives has DC meds that total over $2500. Can we request Banner funding for these medications?
Yes! We can request this for DC. The long paper form should be used for this request as it requires CMO approval.
A patient with an EF of 10% needs a LifeVest for DC, but does not have insurance and cannot afford the charity deposit. Can we cover the cost of the deposit?
No- we cannot cover deposits or enter into rental agreements for DME.
A patient with Medicare is out of SNF days, but needs rehab to DC. Can we fund a SNF stay?
No- we cannot cover what a patient's insurance will not.
True or false: We can cover COBRA premiums for patients who have lost their workplace sponsored insurance.
True- we can request Banner funding for 2 months of COBRA premiums.