SHIPPING AND DELIVERY CHARGES

SHIPPING AND DELIVERY CHARGES

Benefit Code Number
341011
Program of Choice
09 - Oxygen therapy
Province
Alberta
Recommender Required
No
Preauthorization Required
Yes
Provincial Coverage
No
Notes
GENERAL NOTES PRE-AUTHORIZATION REQUIRED UNLESS OTHERWISE INDICATED. COMMAS APPEARING IN THE "PRESCRIBER REQUIRED" AND "RECOMMENDER REQUIRED" COLUMNS INDICATE OR, EG. "MD", "RN" MEANS MD OR RN. WHERE A REQUIRED PRESCRIPTION IS INDICATED: A CURRENT PRESCRIPTION IS REQUIRED AND BE VALID ONE YEAR AFTER THE DATE WRITTEN. WHERE REGISTERED POLYSOMNOGRAPHIC TECHNOLOGIST (PG), REGISTERED NURSE (RN) OR LICENSED PRACTICAL NURSE (LP)/REGISTERED PRACTICAL NURSE (RO) ARE INDICATED AS A REQUIRED RECOMMENDER, THE RECOMMENDER MUST BE WITHIN THEIR SCOPE OF PRACTICE IN THEIR PROVINCE/TERRITORY. WHERE A REQUIRED RECOMMENDER IS INDICATED, A REPORT MUST BE SUBMITTED AND INCLUDE: A. DIAGNOSIS B. FOR PAP THERAPY: TESTING/TRIAL RESULTS CONFIRMING IMPROVEMENT IN CLIENTS SLEEP CONDITION FOR PAP THERAPY (BASED ON A MINIMUM 30-DAY TRIAL PERIOD) FOR OXYGEN THERAPY: ALL FINDINGS FROM THE RESPIRATORY ASSESSMENT, INCLUDING VITAL SIGNS, INSPECTION FINDINGS, PALPATION FINDINGS, AUSCULTATION FINDINGS, OXYGEN RATE, AND/OR ANY OTHER RELEVANT INFORMATION. C.MODEL TYPE AND QUOTE OF REQUESTED ITEMS D. SIGNATURES WITH DESIGNATION FOR ONGOING RENTAL AGREEMENTS, IF DETERMINED THE EQUIPMENT RENTAL HAS/WILL RESULT IN PAYMENTS EXCEEDING THE PURCHASE PRICE, THE RENTAL AGREEMENT SHOULD, WHERE POSSIBLE AND WHEN DETERMINED APPROPRIATE UNDER THE CIRCUMSTANCES, BE TERMINATED AND THE EQUIPMENT PURCHASED. THE RENTAL FEE OF THE SYSTEM IS TO BE DEDUCTED FROM THE PURCHASE PRICE (IF APPLICABLE). PROVIDERS MUST SUPPLY TRAINING ON THE SAFE USE OF OXYGEN THERAPY AND RESPIRATORY EQUIPMENT AND ENSURE THAT THE CLIENT CONTINUES TO USE THE EQUIPMENT PROPERLY DURING FOLLOW-UP APPOINTMENTS. A BENEFIT NOT LISTED IN THE BENEFIT GRID MAY BE CONSIDERED BY EXCEPTION WITH MEDICAL JUSTIFICATION. SPECIAL NOTES