?s for Discharge Planners/Case Managers

[ski-nurse563]

I am trying to understand how patients get orthotic/prosthetic supplies at/after discharge (I am not a discharge planner). Specifically, for patients who are discharged with pleural catheters & are doing self-drainage at home (i.e. they don't need any nursing care per se). Are they discharged with a supply of drainage bottles/bags, and if so, how does the hospital bill for that? If they need more supplies at home, how do they get them? I have been told that home health agencies won't supply pleural catheter drainage bottles because they can't bill for them. Does anyone have any experience with this?

I appreciate any help I can get on this!

[Lucy4]

I am a discharge planner and occassionally discharge a patient with a Pleurex catheter. The patients where I work are sent home with 3 kits and then I order kits to be delivered to their home. Pleurex catheter kits can be ordered thru Edgepark Medical Supply Company - google for website. I set my patients up with home care initially. Home care may be able to order for Medicare recipients - paid at 80% and patient is billed for 20%. The agencies do not supply the kits themselves. Same with VACs - KCI has a script form that is completed by MD and I fax to company. KCI obtains insurance/medicare auth and sends VAC and supplies to patient's home or the hospital for homegoing.

[ski-nurse563]

Thank you, Lucy-- does the hospital bill separately for the 3 bottles that the patient is sent home with? Is it billed as part of the inpatient stay (i.e. wrapped into the DRG)? Or is it billed to the Medicare intermediary as a P/O supply? When you order the kits for home delivery, do you personally have to do insurance verification etc?

You are a huge help--thanks again! :bowingpur

[Ginger's Mom, MSN, RN]

The bill is sent to the patient's insurance company or the patient needs to give a credit card.

Sometimes the as the case manager you have to jump through hoops to have an expensive item covered.