ARO Enrollment
How many payment methods can be on file for a patient enrolling in ARO?
One
What should patient's insurance be listed as when building a cash pay order?
CASH PAY - Cash Pay - Control IQ
or
CASH PAY - Cash Pay - Basal IQ
Do we charge Kaiser patients for expedited shipping?
No, do not add any freight charges to a Kaiser patient's supply order
What action do you take if a patient requires authorization but the current one is expired?
Create a task to IVS Supply rep linked in patient account
What resource does the department have to reference SOPs or other important documents?
Sharepoint
These two payors do NOT need a saved card on file to enroll in ARO, however the threshold must reflect $0.00
CCX and HomeLink
What order type is used when building a cash pay order?
Standard Supply Order
How soon can Kaiser patients re-order supplies?
As soon as 30 days after their previous order
Kaiser authorizations take the place of SMNs for patients who have Kaiser as primary?
SMN in only needed if Kaiser is secondary to a NON-Kaiser primary (Atena, Cigna, etc)
What are the two documents required to have on file in order to ship orders (for most patients)?
PIF and SMN
In addition to creating a verbal consent task, what three fields under Supply Order Info tab must be updated to complete ARO enrollment?
Enrolled in ARO, CC Threshold and Cartridge/ Infusion Set Quantity
Does a miscellaneous order need an opportunity?
No, you can create a new order without building an opportunity
If a patient has Kaiser as their primary and any other type of secondary coverage (Kaiser or NON-Kaiser) they are covered at 100%?
True, make internal note *dual coverage covered at 100%* and do not collect OOP
Do all CareCentrix (CCX) patients require authorization?
No, only True Blue plans require auth- If unsure reference current completed or previous completed IV or task IVS Supply rep linked in patient account
Are pictures of the front and back of patients insurance cards are required to be on file?
Yes, only exception is patients with Kaiser as primary
If a patient has a $10 copay per line item and they always order cartridges and infusion sets, what should their threshold be set at?
$20 or higher
If you uncheck reimbursable boxes in the opportunity and close as won you do not have to uncheck them again in the order?
False, unchecking the boxes in the opportunity does NOT carry over to the order. Best practice is to always uncheck reimbursable boxes in the order before flipping to AR Review.
Can we always request new authorization on behalf of Kaiser patients?
No, we can only request authorizations for patients under certain circumstances- review SOP for specific breakdown
What two places can you reference to find out if patient requires authorization?
Patient plan linking message or the completed verification under the Authorization Info section
What piece of information should NOT be included in the internal note when building a supply order for a patient?
Shipping Address
Lisa has a BCBS of Kansas plan and gets her supplies every 30 days. She has a change frequency of every 2-3 days, which means she would receive her supplies based on a 1-2-1 schedule. She has a $500 deductible, and just paid $160 for one box of each of her supplies. What should her threshold be?
$320 or higher
Which miscellaneous items REQUIRE adding shipping and what are the associated costs?
T:Case - $5.95 shipping
1 box of Adhesive sleeves - $8.00
What two scenarios are PIF and/ or SMN required to ship a supply order for a patient who has Kaiser insurance?
PIF only required if pt has a NON-Kaiser secondary
or
PIF/SMN required only if Kaiser is secondary to a NON- Kaiser primary (Atena, Cigna, etc)
What two places can you reference to find out if authorization has expired or not if the dates are not listed in the Supply Order Notes?
Hardcopy document in patient's Sharepoint or Pre-authorizations tab under Related within the patient insurance plan
Can you verify quantity of supplies to send a patient by looking at their previous order?
No, previous order may have shipped in error. ALWAYS verify with the most recently signed SMN in patient documents