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ENTER PATIENTS DATA WITH PRESCRIPTION INFO& DIAGNOSIS CODES

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It very important to understand that writing prescriptions are the
most frequent transaction in the physician office environment.

Doctors/82740599.jpgBASIC REQUIREMENTS FOR SUBMITTING PATIENTS USING MEDICARE PART B OR PRIVATE FEE FOR SERVICE (PFFS) INSURANCE POLICY:

MEDICARE POLICY OF REQUIRING A PHYSICIAN PRESCRIPTION FOR EACH ITEM HAS BEEN REINSTATED RETROACTIVELY.
 
WWW.MEDICARE.COM: “For any item to be covered by Medicare, it must 1) be eligible for a defined Medicare benefit category, 2) be reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member, and 3) meet all other applicable Medicare statutory and regulatory requirements. For the items addressed in this medical policy, the criteria for "reasonable and necessary" are defined by the following indications and limitations of coverage and/or medical necessity.”

ALL PHYSICIAN PRESCRIPTION MUST INCLUDE; PATIENT NAME, DOB (OPTIONAL), EQUIPMENT DESCRIPTION, DIAGNOSIS CODE FOR THE EQUIPMENT AND MUST BE SIGNED AND DATED BY THE PHYSICIAN.

As an Advocate you should advice all patients to schedule an appointment with their physician. Why schedule an appointment? There 20 million Medicare Patients that visited a doctor twice a year and some every other year. If they really need the Home Medical Equipment and their No Cost To Them Then they should participate and helpful in getting what they really need from their doctor. ALL HOME MEDICAL EQUIPMENT REQUIRES A PHYSICIAN PRESCRIPTION WITH PATIENT NAME, DOB (OPTIONAL), EQUIPMENT DESCRIPTION, DIAGNOSIS CODE FOR ALL HOME MEDICAL EQUIPMENT AND MUST BE SIGNED AND DATED BY THE PHYSICIAN!!!




Doctors/77136657.jpgWith the doctor signature on the Physician Prescription Form #PPF200 and/or The Physician Prescription Mobility Form #PPM200, or the CMN Knee Orthosis Form #CMNK200, with the proper ICD 9 Diagnosis Codes check.
 
Your documents are now valuable. And should be organized in the proper manner and faxed with AAHFed InBound Fax Cover, questions answered.

We do not need the Physician Fax Cover, please do not fax it to us.

Well-organized submission gets process quicker, because it ready to be process with Medicare. Fax the document headfirst, do not fax backward. Unorganized submission are delayed, because someone has to sort through them.
 
Additional Good New: We now accept Medicare Part C or Advantage through United Health Care companies and Well Care Health Insurance of Arizon PPO plan. United Health Care companies are one of the largest health care insurance companies in the country.

We ship within the week we received the physician prescription with matching ICD 9 Diagnosis Codes for Home Medical Equipment.

Medicare reimbursement is 4 to 6 weeks after the Patient have received equipment and have signed the above forms. We will 
pay your commission within 72 hours of receiving Medicare Reimbursement for your patients.
  1. Enter The Patient Information below and Select their Home requested Medical Equipment
  2. Complete AAHFed Patient Fax Cover with Patient required paperwork Per Medicare Want List Below to: 206 984-4066
  3. Mail all Patient's Signed Forms with their Originals Signatures. Every Patient must sign the following Forms:

    Basic Requirements for all Patients Processing Medicare Part B or Private Fee For Service (PFFS) Insurances:

    EVERY PATIENT MUST SIGN THE FOLLOWING FORMS:

    ___ Patient Order Form #POF100
    ___ Physician Prescription Form #PPF200
    ___ AAHFed Hardship Grants #HG300
    ___ Consent for Computerized File
    ___ Equipment Warranty Information
    ___ Assignment of Benefits
    ___ HIPPA

    LEAVE THE PATIENT A COPY OF FOLLOWING DOCUMENTS FOR THEIR RECORDS:

    ___ Patient's Bill of Rights
    ___ Protocol For Resolving Complaints
    ___ Tips for Preventing Falls
    ___ Medicare Supplier Standard

    ALL HOME MEDICAL EQUIPMENT REQUIRES A PHYSICIAN PRESCRIPTION:
     
    ALL PHYSICIAN PRESCRIPTION MUST INCLUDE; PATIENT NAME, DOB (OPTIONAL), EQUIPMENT DESCRIPTION, DIAGNOSIS CODE FOR THE EQUIPMENT AND MUST BE SIGNED AND DATED BY THE PHYSICIAN.

    Medicare Rules from www.medicare.com:

    “For any item to be covered by Medicare, it must 1) be eligible for a defined Medicare benefit category, 2) be reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member, and 3) meet all other applicable Medicare statutory and regulatory requirements. For the items addressed in this medical policy, the criteria for "reasonable and necessary" are defined by the following indications and limitations of coverage and/or medical necessity.

    For an item to be covered by Medicare, a written signed and dated order must be received by the supplier before a claim is submitted. If the supplier bills for an item addressed in this policy without first receiving the completed order, the item will be denied as not medically necessary.”

    There are some Items that also require a specific CMN (Certificate of Medical Necessity) and physician prescription in order to bill Medicare. These items are:

    •    Motorized Wheelchair
    •    Power Operated Vehicle
    •    Manual Wheelchair
    •    Seat Lift
    •    TENS Units (after the trial period)

    ALL OF ABOVE CMNS WILL BE PROCESS INTERNAL BY AAHFED FOR FASTER RESULT!
     
    The following Home Medicare Equipments doesn’t require a CMN, but a Physician Prescription, with the patient information and proper IDC 9 Diagnosis Codes as describe above:

    •    Canes
    •    Walkers
    •    Gel Cushions
    •    Mattress
    •    Heat and Cold Therapy Pump
    •    Nebulizer
    •    Knee Brace
    •    Back Brace
    •    Elbow Brace

    Medicare does revisions that require some documentation. That documentation could be the following:

    “Section 1833(e) of the Social Security Act precludes payment to any provider of services unless "there has been furnished such information as may be necessary in order to determine the amounts due such provider". It is expected that the patient's medical records will reflect the need for the care provided. The patient's medical records include the physician's office records, hospital records, nursing home records, home health agency records, records from other healthcare professionals and test reports. This documentation must be available upon request.”
    to:                                                                       
AAHFed
1778 Jackson Ave
Patient Processing
Memphis, TN 38107

Gender
Male
Female
 * required
Patient First Name

Middle Initial
 * required
Patient Last Name
Patient Birthday * required
Month
Date
Year
 * required
Patient Address
City
State

Zip Code
Patient Medicare#
Month
Effective Date Part B
Date
Year
Please Select Home Medical Equipment with a Physician Prescription, with Patient Information and Correct ICD 9 Diagnosis Codes as describe below.
Month
Date
Year
ALL PHYSICIAN PRESCRIPTION MUST INCLUDE; PATIENT NAME, DOB (OPTIONAL), EQUIPMENT DESCRIPTION, DIAGNOSIS CODE FOR THE EQUIPMENT AND MUST BE SIGNED AND DATED BY THE PHYSICIAN.

 * required
Advocate Name

 * required
Advocate Code
Advocate Email
Add All Physician Prescriptions for Home Medical Equipment with ICD 9 Diagnosis Codes below.

Patient Signature Required
Please check Forms with Patient's signatures

Patient Order Form #POF100
Physician Prescription Form #PP200
CMN for Knee orthosis Form #CMNK200
Physicians Prescription Mobility #PPM200
Patient Signature Required
Please check Forms with Patient's signatures
Hardship Grants #HG300
Home Assessment #HAEF200
Patient Consent for Computerized
HIPPA Form
Did Patient Receive Copies of these Files?
Equipment Warranty Information
AOB Assignment of Benefits
Patient's Bill of Rights
Protocol For Resolving Complaints
Tips for Preventing Falls
Print

 
Thank you for submitting your Patient information above. We will email you a tracking number within seven business days, provided that the Patient has been or is being Diagnosed with an Aliment or a Disease. Prior to pressing the submit button, make sure your Patient's Physician has checked all of the Patient's ICD 9 Diagnosis Codes. The Patients requested Home Medical Equipment HCPCS Codes must match Patient ICD 9 Diagnosis Codes.
 
Please Check Patient Home Medical Equipment Eligibility prior to Faxing it to the physician office, when possible.
 
For example: If a Medicare Patient has been diagnosis with one or more of the following ICD 9 Diagnosis Codes they are eligible for a Scooter (K0806).
 
401.9    Hypertension, unspecified
443.9    PVD Peripheral vascular disease
401.9    HTN (Congestive heart failure)
440.9    CAD (Coronary Artery Disease)
411.89  CHD (Coronary insufficiency)
428.0    CHF (Congestive heart failure)
443.9    PVD (Peripheral vascular disease)

250.60 (Diabetic Neuropathy)
ICD-9 Diagnosis Codes for HCPCS Codes

Knee Brace – L1832
HomeMedicalEquipment/8_275ROMHingedKneeBrace.gif
ICD-9 Diagnosis Codes
Arthritis, Rheumatoid (714.0, 714.1, 714.2, 714.3)
Osteoarthritis (715.16, 715.26, 715.36, 715.96)
Dislocation of Knee (836.0 836.69)
Meniscal Cartilage Derangement (717.0, 717.5)
Stress Fracture of Tibia of Fibula (733.93)
Knee Ligamentous Disruption (717.81 thru 717.9) 

Lumbar-sacral Back Brace/Orthoric: L0637
HomeMedicalEquipment/Backbrace.gif
2009 ICD-9-CM Diagnosis  Codes
Lumbago (724.2)
Spinal Stenosis (724.0)
Muscle Weakness (728.87)
Spondylolisthesis (756.12)
Lumbar Disc Displacement (722.10)
Lumbosacral Spondylosis (721.3)
Lumbar Strains/Sprain (847.2)
Spinal Disorder (724.9
Lumbosacral Spondylosis (721.3)
Lumbar/Lumbosacral Intervertebral Disc Degeneration (722.52)

Elbow Brace – L 3760
HomeMedicalEquipment/RomElbow.gif
 ICD-9 Diagnosis Codes
Arthritis Rheumatoid (714.0)
Congenital Deformity of Knee (755.64)
Osteoarthritis (715.16, 715.26, 715.36, 715.96)
Effusion of upper arm joint (719.02)
Joint Pain involving upper arm (719.42)
Pathol. Dislocation upper arm (718.22)
Recurrent Dislocation upper arm (718.32)
Uplift Seat Assist E0629 & E0628
ICD-9 Diagnosis Codes
715.90 For an unspecified site
715.95 For arthritis of the Hip
715.96 For arthritis of the Knee
Arthritis Arthropathy 716.9
Osteoarthritis 715.0 & 715.09
Osteoarthritis 715.8 & 715.85
Rheumatoid unspecified 715.0
NEUROMUSCULAR DISEASE 358.9
DEGENERATIVE JOINT DISEASE 715.09
DEGENERATION OF LUMBAR DISC 722.52

Heat Therapy Pump – E0217
HomeMedicalEquipment/Hea_Pump.jpg
 ICD-9 Diagnosis Codes
Arthritis, Rheumatoid (714.0, 714.1, 714.2, 714.3)
Osteoarthritis, NOS, unspecified (715.90)
Arthropathy, unspecified (716.90)
Sponylosis (721.90)
Lumbago, Sciatica (724.2, 724.3)
Pain in Joint, ankle and foot (719.47)
Muscle Spasm (728.85)
Edema (782.3)

Low Air Loss Pressure Mattres 8" - E0277RR
HomeMedicalEquipment/LowAirLossPressureMattres.gif
ICD-9 Diagnosis Codes
707.02 - 707.5 (DIABETES MELLITUS)

Deluxe Three Wheel Scooter K0806 & K0807
HomeMedicalEquipment/scooter_celebrityx.gif
ICD-9 Diagnosis Codes
401.9 HTN (Congestive heart failure
440.9 CAD (Coronary Artery Disease)
411.89 CHD (Coronary insufficiency)
428.0 CHF (Congestive heart failure
443.9 PVD (Peripheral vascular disease)
250.60 (Diabetic Neuropathy)

Power Chairs K0823 & K0823BP
HomeMedicalEquipment/PowerStairChair.gif
 ICD-9 Diagnosis Codes
436.00 (CVA-Stroke)
340.00 (Multiple sclerosis)
491.21 COPD Chronic Obstructive Pulmonary Disease
343.1 Hemiplegic
428.0 CHF (Congestive Heart Failure)

Seat lift Assist up to 300 lbs.    E0629NU
Seat lift Power    E0628NU
HomeMedicalEquipment/SeatliftAssist.gif
ICD-9 Diagnosis Codes
Arthritis Degenerative (formerly 715.9)    715.90    
Unspecified site 715.95 For arthritis of the hip
Unspecified site 715.96 For arthritis of the knee
Arthritis Arthropathy (formerly 716.9)    716.9   
Osteoarthritis (formerly 715.0)        715.00    For an unspecified site
Osteoarthritis (formerly 715.8, 715.80,  715.85)
Rheumatoid (formerly 715.0)          
 NEUROMUSCULAR DISEASE  (358.9)
DEGENERATIVE JOINT DISEASE  715.09)
DEGENERATION OF LUMBAR DISC  (722.52) Plus Seat Lift CMN

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