 Does
Med-Response bill Medicare or theInsurance Company for the Patient?
|
|
Yes, Med-Response will bill Medicare or your insurance company when coverage is provided. However, Med-Response must have a written prescription from the doctor before billing Medicare and some insurance companies. |
| What is required before Medicare will reimburse the medical equipment I receive at home?
|
|
A written prescription called the Certificate of Medical Necessity (CMN) or Written Confirmation of a Verbal Order from your doctor is always required. Med-Response cannot bill Medicare without this. Furthermore, all Medicare guidelines must be met. |
|
When
is a patient responsible for their $100
deductible with Medicare?
|
|
A patient has a $100.00 deductible with Part B Medicare the beginning of January every year. The patient will be responsible to pay the provider that supplied the service. The only way a patient would not be responsible for the deductible is when you have a co-insurance that pays for the Medicare deductible. |
|
Do I have to initiate the paperwork
necessary for Medicare payment?
|
|
No, your doctor must first give you or Med-Response, Inc. a written or verbal order, and then Med-Response sends the Certificate of Medical Necessity (CMN) or Physician's Order to Medicare. The form must be completed accurately by the doctor, signed, and dated before Medicare will reimburse us. |
|
What do the terms
"assigned" and
non-assigned" mean regarding my coverage?
|
|
If a piece of equipment is "assigned" then the supplier accepts the Medicare-approved fee for the piece of equipment. This means Medicare will pay the supplier 80% of the approved fee. The patient must then pay the 20% coinsurance amount. A "non-assigned" item means the supplier sets the charge for the piece of equipment. The patient must then pay the supplier the full amount. In this situation, Med-Response would still submit the claim to Medicare; and if the item is covered, then Medicare reimburses the patient 80% of the approved fee. |
|
What does "capped rental" mean
regarding
Medicare and what it covers?
|
|
A supplier must give the patient the option to purchase a rented piece of equipment that is a "capped rental" item during the tenth month of usage. The patient may choose to continue renting the item. However, rental payments cannot be made after 15 months; after which, the supplier charges a maintenance fee every six months thereafter. The fee is equivalent to one month's rental. |
|
Does Medicare cover bedside commodes?
|
| Yes, if the patient is bed or room confined. |
|
Does Medicare cover walkers....with wheels
and brakes?
|
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Yes, walkers are covered, and wheels; but brakes are non-assigned items and depend on the diagnosis given by the physician. |
|
Does Medicare cover oxygen? If, so what medical
information must be provided?
|
|
Yes, Medicare reimburses regardless of the amount oxygen used or the type of oxygen equipment you need (concentrator, gas cylinder or liquid oxygen systems). A doctor's order for a blood gas analysis report must be provided by the doctor, certifying a PO2 level of 55 mm HG and/or Saturation level (SAO2) of 88% or below when at rest and when breathing room air drawn during a non-accute state. An Oximeter Reading is also acceptable. Medicare also requires re-testing periodically before treatment can be continued and fees reimbursed. |
|
Does Medicare pay for oxygen that
is
ordered only on an "as needed basis"?
|
|
No, Medicare will not cover the use of oxygen when it is *PRN (As Needed by patient). |
|
Does Medicare cover walking aids and wheelchairs simultaneously?
|
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No, unless it is a rehabilitation case only and the patient needs a walker or cane to get in-and-out of the wheelchair. |
Will Medicare Part B cover DME items
used by a patient in a Skilled Nursing Home?
|
| No, Medicare does not provide this coverage. |
Will Medicare give prior authorization
for a durable medical equipment item?
|
|
Medicare will prior approve only certain items such as TENS Units, Power Operated Vehicles and Seat Lift Mechanisms. This approval does not guarantee payment. |
 Will Medicare pay for repairs of Patient
Owned equipment?
|
|
Yes, as long as the equipment is still deemed medically necessary and repair is less costly than replacement. |
 Does Med-Response charge the patient
for billing Medicare or other insurance
companies and for obtaining forms necessary
to bill?
|
| No, this is a service provided by Med-Response, Inc. |
 Does
Med-Response train the patient on
equipment it sells to the patient?
|
|
Yes, Med-Response trains the patient to operate his/her equipment, and also provides literature. |
Med-Response, Inc.
P.O. Box 3225
Bluefield, WV 24701
Phone: (800) 635-1948 Fax: (304)
589-6319
EMAIL US:
medresponse@medresponse.com
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