Instruction manual

Medicare Claim Filing & Billing Issues
This catalog is a continuation of the service provided in the Mayo
Clinic Store. Products were carefully chosen for reliability and
value. As a not-for-prot organization, proceeds from products
purchased in our catalog support medical education and research
at Mayo Clinic. This important work helps enhance the lives and
well-being of people all around the world. Established in the late
1800s by Minnesota doctors William and Charles Mayo, Mayo
Clinic is now one of the world’s largest group practices staffed with
more than 2,000 physicians dedicated to continuing the Mayo
heritage of medical excellence and providing caring, individual
attention to each patient.
Items Required for an Initial Set-Up
for Medicare/Medical Assistance
Recipients
»»
Physician’s Prescription
»»
Home or in-facility sleep study demonstrating qualifying need
for therapy equipment
»»
Face-to-Face physician visit documentation; this visit should
indicate symptoms indicating the necessity of the sleep study
»»
Medicare information
Beneficiaries Entering Medicare
A person who was receiving supplies under commercial
insurance & is transitioning to Medicare coverage must have
a face-to-face evaluation by the treating physician after having
rst signed up for Medicare. The physician must document
specic information in the medical record and we must have
this information in our les before we can submit supplies for
Medicare coverage.
Switching Providers
If a person would like to obtain supplies from our store we will need
specic information to be able to send the items to medicare.
»»
A new prescription
»»
Copy of Home or in-facility sleep study demonstrating qualifying
need for therapy equipment
»»
Face-to-face physician visit documentation demonstrating the
reason the original sleep study was indicated
»»
Medicare information
Competitive Bid
In certain geographic areas of the country Medicare has used
a bidding process for providers of sleep therapy supplies and
equipment. We are not a contracted provider with Medicare in
these competitive bid areas and consequently cannot provide
sleep therapy equipment and supplies to you and bill Medicare.
We can assist you in nding a store in your area that may be
able to provide services for you. In some instances we can help
traveling patients who reside in a competitive bid area with supply
needs. Again, or staff will help you determine if it is appropriate for
us to provide you with supplies.
Billing Issues
If you have questions or concerns about your billing, please call our billing ofce at 888-303-9354 prompt #2.
We specically do not state that your insurance(s) will cover the cost of the equipment and supplies. Coverage
determination is between the insurer and the insured. The user is responsible for payment of amounts not covered
by insurance.
Medicare Claim Filing Policy
The Mayo Clinic Store — Sleep Apnea Supplies is a participating Medicare B provider. We will le an assigned Medicare B claim
form on your behalf. However, we must have specic information to le a claim.
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Order Toll-Free 888-303-9354 • Fax [phone] • Prices in blue are generally not covered by insurance