iPath360 Style
J2787 code is
Photrexa
Name 2 patient identifiers
Date of birth
Zip code
Address
Name 3 ways we can verify income eligibility for PAP
SSN
W2
1040
SSI Letter
Pay Stubs( 3 months)
Certified Letter
True or False
RxAP is for both commercial and Medicare claims
False- RxAP is for commerial claims only
Name the manufacturer of the products that we service
Glaukos
Call opening for inbound call
Thank you for calling Glaukos iPath360, my name is ____, how may I help you
How do you authenticate a Payer?
Patient’s name
2 patient identifiers
NPI/Claim/Auth # Tax ID or Insurance ID
A PAP application is good for how many days
90 days from the patient's signature
J2787
Acquisition Cost for 2021
$3130
Name the rare eye condition that Photrexa is used for
Keratoconus
What is the CPT codes for iStent?
0191T and 0376T
Authenticate an FRD
FRD First and last name
Phone number
A patient has no income , what information is needed to process for PAP ?
(2 answers)
A notarized letter from the patient or a letter from the providers office attesting that the patient has no income
J2787
Acquisition cost for 2022
$3435
Name 3 FRD
(If you are a case managers it can not be your own FRD)
Duy, Rich,Erin,Steve,Jody,Brian, Pam,Brandy,Nick and Mark
When working an Orsini enrollment what code/codes do you verify for benefits?
0402T Only unless the provider request that we do both
A caller is not able to authenticate the call, how do you proceed
Inform the caller that you will be not be able to assist the call without authenticating. Only general questions can be answered.
True or False
A patient has Tricare insurance, patient is eligible for PAP
False- Tricare insurance has coverage for crosslinking and we will verify benefits. This plan is not eligible for PAP
A low paid claim was received. The difference from the allowed and acquisition cost is $150. Is this claim eligible for RxAP?
Yes-if the difference is $150-$1000 you send the case to RxAP
FRD stands for what
Fields Reimbursement Director
The iLink copay savings program for commercial insured patients will cover out of pocket copay expenses up to what amount?
A HCP office received a PAP kit and they are calling to verify what patient the kit is for. How do you authenticate the call
Gather the PAT number (can be find on the packing slip) , at that time we can provide the patient’s name only.Then the provider will verify 2 patient identifiers along with provider name,NPI or TAX
A patient is approved for PAP and the office wants to know if they can bill for the medication and procedure. What is the answer
The medication is donated free of charge and can not be billed by the office. For the billing of the procedure refer the office to the FRD
RxAP credits can be used for reimbursement of the cost of the medication that has already been purchased prior to the RxAP approval
Fasle- RxAP credits are for future purchase of the product
Name the Director of Patient and Provider Services
Valerie Ditterline