Medicare/Medicaid
TRUE OR FALSE
Patient who is at the hospital has Medicare Part A and being ordered a hospital bed. How do we proceed?
We are not able to. Part A only covers hospital stays. Patient would have to pay OOP and sign ABN.
Where can our licensing be found?
Front office.
Patient started out at 3lpm but is now needing 6lpm. How do we take care of the patient?
We need to call the patient to make them aware of the new increase according to the orders. Next, we put in an exchange ticket for the 5 liter concentrator to be switched to a 10 liter concentrator.
Who is the Director of Corporate Complaince?
Lindsay Armstrong
What do we do with the machines patients want to send to ResMed for repair?
We need set them up with a loaner if they want one and then make a note in the account on what is wrong with machine for us to create the RMA.
The beneficiary has a medical condition which requires positioning of the body in ways not
feasible with an ordinary bed. Elevation of the head/upper body less than 30 degrees does
not usually require the use of a hospital bed. The patient is able to use the remote independently.
When should a patient be called and explained their financial responsibility?
Before delivery is scheduled.
Patient is being ordered Oxygen. The walk test comes over as followed:
Room air at rest 90%
Room air with exertion 85%
Recovery rate with Oxygen 87% at 4lpm
Can we accept this?
No. The recovery rate needs to get up to a safe level of at least 90%
The Reporting Escalation Process consists of 4 steps, which must be completed when there are actual or suspected concerns of non-compliance. What is the order of the 4 escalation steps?
1. Report to your supervisor
2. Consult Policy and Procedure
3. Escalate to Reginal Leadership
4. Report to Corporate Compliance
What happens if the patient has already used their 30 or 90 day mask exchange?
They would have to pay OOP pricing.
What is an ABN and what is the purpose of it?
Advance Beneficiary Notice is for Medicare patients who may not qualify or are missing documentation and if Medicare does not cover the DME the patient is responsible.
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
Patient who is on 4lpm is traveling out of state within the next few weeks and is looking to reserve a TOC. What do we do to assist them?
Advise that the TOC only goes to 3lpm continuously but offer sister companies in that area that may be able to assist with a home setup at no charge.
Which of the following are examples of actions that could implicate the Anti-Kickback Statute?
A. Offering or paying anything of value to induce someone to refer a patient to Adapthealth
B. Soliciting or receiving anything of value for the referral
C. Offering or paying anything of value to induce someone to purchase services from Adapthealth
D. All the above
D. All the about
A non-patient to use came to store to get a download for DOT. Are we able to assist them?
Yes, we can. There is a $25 dollar charge for a non-patient.
TRUE OR FALSE
A knee walker is a billable item to Medicare.
Who is our Chief Compliance Officer?
Wendy Russalesi
News indicates a bad snowstorm is coming that will shut down the roads. An Oxygen patient calls in to get extract tanks for emergencies. Are we able to provide this for them?
No. We can only provide the allotted number of tanks they normally get and advise the patient in case of emergencies they need to call 911.
It is the duty of every __________ to protect the confidential information they have been entrusted with, regardless of its media form.
A. Covered Person
B. Physician
C. Customer Service Representative
D. Chief Executive Officer
A. Covered Person
What is the timeframe for Compliance for a PAP patient?
They have to use the machine for 4 hrs or more 30 days out of a 90-day period.
What does DMEPOS stand for?
Durable Medical Equipment, Prosthetics, Orthotics, and Supplies.
What is the False Claims Act?
Knowingly submitting or causing the submission of false or fraudulent claims for payment to the federal government.
TRUE OR FALSE
Patient's concentrator is alarming and showing a red light. We advise them to call 911 for help.
Which of the following is prohibited by the Anti-Trust Statute?
A. Dealing fairly and openly with customers and suppliers
B. Enforcing of contractual obligations
C. Offering AdaptHealth services and products to customers and suppliers
D. Using coercive practices or threatening customers
D. Using coercive practices or threatening customers
When completing a mask exchange where do we indicate what previous mask they had?
The note section in the sales order under the item but also it needs to be noted in the main account.