Medicare/Medicaid
True or False:
For Medicare to allow billing privileges AdaptHealth must be accredited by CMS approved accrediting agency.
True
How do you handle a referral you cannot accept?
If a patient is either bed bound or wheelchair bound, how do they perform the walk test?
They can perform anytime of exertion testing that causes their SATS to drop.
Yes, located in the break room.
Is a patient able to switch masks if one is specified on the prescription?
No. We would need a new RX.
Patient is being ordered a HD wheelchair. What does the minimum weight have to be?
300lbs
Where can you find the Employee Rights displayed?
Kitchen
If a patient's O2 levels are at 5lpm would they be able to try to qualify for a POC?
No. They have to be 3lpm or lower
What is the timeframe to notify the referral source of an order we cannot take?
5 days
What insurance policy sometimes will have a four month rental?
BCBS with a final pay-out on the fourth month.
True or False:
Medicaid allows a 30lb buffer?
True
How would you report and incident or accident?
Report immediately to management
What is the O2 "contract" time frame?
Patient has less than a year to switch companies if they want to. After a year they are in the billing stage for 3 years and maintenance for 2 years.
Patient wants a retail price for an item. Where can this be found?
In the Brightree system when creating a retail sales order
Do we need a prescription for and Oxygen patient to bleed in O2 with their PAP machine?
Yes
How often will Medicare/ Medicaid cover a new mattress for a Hospital bed?
Medicare - 5 years
Medicaid - 3 years
Where can the patient's find warranty information?
In the Welcome Guide
Patient is being ordered Oxygen with SATS showing 96% room air, 86% with exertion and 88% recovery rate on 2lpm. Do they qualify?
No. The recovery rate has to be 90% or higher.
Do you get an emergency contact number for all referrals?
Yes, it is collected at the time of setup in the patient documentation.
Does a re-PAP patient qualify for a 30-day mask exchange?
No. Only new PAP setups.
Patient was provided a Power Wheelchair in 2023 through their Medicaid insurance. Now they are being ordered a standard wheelchair. How do we process this order?
We cannot. Medicaid will reset every 3 years and would need to wait until that time frame to re-file.
How do you stay up to date with training?
We received an order through the fax line showing the walk test results on the order itself. Do we still need the actual preformed walk test?
Yes, as the testing on the order shows the DR signed off on testing.
Are the TB rates available to you for the counties that you service?
Yes, a copy is located in the break room with the plan and rate for each county
Patient calls in saying their machine keeps cutting off a night due to high leaks. How would you troubleshoot this?
Suggest testing the seal of the mask before going to bed. Making sure the tubing is connected to mask firmly. Advise to make sure the water chamber is secure in the machine.