cpap best practices/worst practices


Post on 02-Jan-2016




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CPAP BEST PRACTICES/WORST PRACTICES. Explain Your CPAP Program…. Intake Process…. Who completes your intake? Customer Service Representatives Respiratory Therapist Sleep Tech Billing Department Any Staff Member That Is Available How Quickly Do You Contact The Patient? - PowerPoint PPT Presentation



  • Explain Your CPAP Program.Intake Process.Who completes your intake?Customer Service RepresentativesRespiratory TherapistSleep TechBilling DepartmentAny Staff Member That Is Available How Quickly Do You Contact The Patient?24-48 Hours After Receiving The Order24 Hours After Verifying CoverageSame Day For Orders Received Before 4:00 Pm.Who Contacts The Patient To Schedule Set-up?Respiratory TherapistCustomer Service RepresentativesSleep Tech

  • Explain Your CPAP Program.Documentation Required Before Setup.What Do You Require Before You Deliver The Equipment?All Qualifying Sleep StudiesComplete And Accurate Initial Face To Face Medical Records According To Medicare GuidelinesAppropriate PrescriptionBerlin Questionnaire/Epworth Sleepiness ScaleVerify That Certified MD Interpreted The StudyStringent Adherence To Medicare GuidelinesIVR Prior Authorization If Required By Payor Sleep Studies and a Prescription We pursueother documentation afterwards

  • Explain Your CPAP Program.Set up / DeliveryAt Office Or Patients HomeBoth90% In Patient Residence / 10% At OfficeWho Schedules The Setups?Respiratory TherapistCustomer ServiceHow Quickly Do You Attempt Delivery?Based On Customer PreferenceBased On Schedule AvailabilitySame Day Of OrderWithin 48 Hours Of Receiving OrderWithin 2- 3 Days Of Receiving OrderWe Average 4 Days

  • Explain Your CPAP Program.Follow up/ComplianceHow Do You Follow Up After Delivery? Who?RT That Delivers Equipment Maintains All Contact Until Patient Is Doing WellDedicated CPAP Compliance Coordinator The Employee That Makes Initial Contact With The Patients Should Maintain That ContactFrequency.3 Calls In 30 DaysDay After Delivery And PRNWithin 7 Days Of The SetupDay 3, Day 10, Day 35Based On Need How Are You Monitoring Compliance?Smart Cards/ SD CardsPhone Call To Patient And Asking Them to Retrieve Data From MachineWireless ModemsWired ModemsRT Visit To Patient To Retrieve Data

  • Explain Your CPAP Program.Patient Follow-Up Face To Face Visit Do You Assist The Patient In Scheduling This Appointment?YES!!!!!!!Call Doctor At Time Of Set-Up To ScheduleCompliance Coordinator Notifies Doctor Once Patient Is Compliant So That A Follow Up Appointment Can Be Scheduled.How Do You Confirm That The Visit Occurred?Compliance Coordinator Contacts Patient And/Or DoctorBilling Dept. Contacts Patient And/Or Doctor

  • Explain Your CPAP Program.Follow Up Visits With PatientsDo You Go To Patients Home/Office Or Require They Come To Your Office?BothWhatever The Patient PrefersHowever Setup Was HandledDepends on Payor Source How Do You Get Compliance Information To Doctor?Compliance Coordinator Sends As Soon As Available Via Email or FaxSent To Billing Department Then To DoctorSales Reps Deliver To Make It A Sales CallHow Do You Manage This Information?Manufacturer Programs (Encore Anywhere, Res Scan, ResTraxx)Billing Software

  • Explain Your CPAP Program.Challenges / ObstaclesInitial Face To Face Visit# 1 ProblemOften Incomplete And Must Request More InformationRarely Sent With Order And Often Hard To ObtainSolution.. Constant Re-educationMask Issues / Mask Swaps?Average At Least 2 Masks Per Patient Before ComplianceAverage More Than 2 Per Patient Before ComplianceSolution.. Mask Replacement Programs, Continued RT Training, Limited SelectionPressure Issues CPAP To BiPAP Conversion?Aggressive With Patients That Are Non-Compliant Not A lot of Doctor SupportAs Quickly As Pressure Becomes An IssueDifficulty Getting Doctors To Document As RequiredSolution..Education Of Staff, Education of Doctors, Internal Protocol to Direct Conversion, Strong Documentation

  • Explain Your CPAP Program.Challenges / ObstaclesUse of Auto DevicesNot An IssueOften Ordered to Desensitize Patients Prior To Sleep StudiesNo Payor SourceWill Not Dispense Without $$$$$ This Is An Issue With Medicare PatientsOften Prescribed With Initial OrderSolution..Use ABN If Delivering To Medicare Patients Prior To Qualifying Sleep Studies, Do Not Loan Auto Devices, Self-Pay / Indigent PatientsRequire Payment Up-Front To Cover Costs Of SuppliesNot A Big IssueAlways Offer Used Equipment I Am Not A Finance Company No More Than 2 or 3 PaymentsDo You Choose Certain Model CPAP Based On Payor Source?YES!!!!!NO One Basic Model That All Patients Receive