Order Process/Rx
HFCWO authorization requires prior approval for
every referral. Each case presents its own unique set of challenges.
However, Electromed's Reimbursement Department has pioneered unique
referral forms to reduce the paperwork and medical documentation
required from clinic staff. We do everything possible to successfully
gain authorization without tapping the limited time resources of
your group.
1. The medical team completes and faxes:
| A. |
The SmartVest® Referral
Form listing patient demographics, payor information and clinic
contact information (The face sheet of your patient record
may be used.) |
| B. |
Electromed's unique Certificate
of Medical Necessity/Prescription Form (CMN/Rx) that allows you to check
off the reasons for the referral and write a brief patient
note. This form greatly reduces the need for physician intervention
and development of Statements of Medical Necessity and has
been welcomed by the payors as an efficient process to determine
medical necessity. |
| C. |
A standard Electromed
Patient Release,
Assignment and Privacy Form signed by the patient. (If the
patient is not present to sign, we will obtain the necessary
release from the patient.) |
2. An Electromed respiratory therapist
interviews the patient and/or caregiver to gather appropriate
facts that support use of a SmartVest® Airway
Clearance System, including:
A. |
Medical history |
B. |
Current health status |
C. |
Current treatment methods |
D. |
Family, school, and work issues |
3. Electromed verifies benefits
by confirming that a policy is active and there is coverage for
durable medical equipment. We maintain contact with case managers,
utilization review specialists and prior approval departments
until approval is received.
Throughout the prior approval process, our Reimbursement staff will advise
your office and the patient of any additional information needed.
To reach Electromed's
Reimbursement Department, call 1-800-462-1045
|
