CONSENT FORM PROCEDURE

What is an AOB?

The consent form or “AOB” (Authorization of Benefits) is a document that Medical Supply Inc. (MSI) is required to have on file to stay in compliance with DME Supplier Standards. The AOB is explained in detail to a consumer when they initiate services with our company. The form says “Authorization for Release of Information” at the top and has the consumers name and identifying insurance factor on it as well.

This form authorizes MSI to bill the consumer’s insurance company for rendered services; and to release the patient’s privacy information (if need be) to insurance companies, doctor’s offices, etc.

By signing the form the patient avoids any delays in the future services and agrees to all of the following:

  • The patient understands that they have the right to access their health information at any time and that they have the right to request MSI amend any health information that they are given.
  • The patient understands that at any time they have the right to restrict or revoke their consent by contacting MSI.
  • The patient understands that they are aware that MSI will bill them for any deductible and co-payment charges on equipment (if any).
  • The patient understands that if any item was to be denied by the insurance companies it would be noted on the form by a representative at MSI. Furthermore, the patient guarantees payment to MSI if any charges are not covered through the insurance.

Why do we need to obtain AOB?

The consent form is required, in order for our company to stay in compliance with the DME Supplier Standards. The primary reasons we need to obtain the consent form are listed below:

  • To authorize our company to bill the patient’s insurance company for services rendered.
  • To avoid any delays in the patient’s future services.
  • The consumer cannot receive another order from MSI unless we have the consent form on file.

* The consumer cannot receive another order from MSI unless we have the consent form on file.