For patients switching from commercial insurance to Medicare, the following must occur:
- A new office visit with the physician is required to address continued need for oxygen.
- A new qualifying test must be performed within 30 days of the date of Medicare eligibility.
- A new order compliant with ACA (where applicable) must be secured and date stamped.
- A pick up and re-delivery of equipment must occur after the new order is on file and date stamped.
- A new initial CMN must be submitted with the first claim to Medicare.
We touched on the importance of this subject in our blog Do Something Different! Prevent Eligibility Snags where we offered practical tips on how to get ahead of the curve by sending “Happy Birthday” notices to your clients reminding them that they must see their physician in order to continue receiving their equipment under Medicare. Predicting and responding effectively to these disruptions is critical to stabilizing your revenue stream when dealing with rented equipment.
If you want to learn more about responding correctly to interruptions that impact billing and ensure that you are not leaving money on the table, join us Thursday, November 17, at 2 PM Eastern or pre-order the on-demand playback for our webinar, Restart or Extend? Simplifying Medicare Capped Rental Scenarios.