The insurance will NOT pay for supplies if a consumer is in any type of the following facilities:
- Nursing Home
- Rehabilitation Center
Exception to this rule is if the consumer is in an Assisted Living Facility.
- If a representative performs a follow up and was told that the consumer is in a facility, we should inform the caller of the following:
- The supplies have to be temporarily put on hold while patient is in the facility because the insurance will not cover the items that will be delivered.
- Once the consumer is discharged and the consent form was received, services can be restarted given that we have everything that we need to restart the order. Ex. Valid RX, state eligibility is ok
ALWAYS read the NOTES before calling ANY consumer/care manager.
- If you see a note saying “NO AOB, NO ORDER” It means because the AOB is not in, we cannot send the consumer their order.
- If you call the consumer and there is no answer, no voicemail, call all the other contacts.
MAILING OUT AN AOB
When re-mailing the consent form to a consumer, CSRs should be sending all of the following for convenience:
- AOB Form (Consent Form)
- AOB Cover Letter
- Self Addressed Stamped Envelope
CSRs should highlight where the consumer or authorized representative must indicate the date and signature.