/policies/,/policies/administrative/,/policies/administrative/uwhc/,/policies/administrative/uwhc/uwhc-wide/,/policies/administrative/uwhc/uwhc-wide/fiscal/,

/policies/administrative/uwhc/uwhc-wide/fiscal/232.policy

201509247

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UWHC,

Policies,Administrative,UWHC,UWHC-wide,Fiscal

Medical Item Procurement for Patients at Discharge (2.32)

Medical Item Procurement for Patients at Discharge (2.32) - Policies, Administrative, UWHC, UWHC-wide, Fiscal

2.32

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Administrative (Non-Clinical) Policy
Category:
 UWHC only (Hospital Administrative-entity wide)  UWMF only (entity wide)
 UWHC Departmental (indicate name)  UWMF Departmental (indicate name)
 UWHC and UWMF (shared)
Policy Title: Medical Item Procurement for Patients at Discharge
Policy Number: 2.32
Effective Date: September 1, 2015
Chapter: Fiscal
Version: Revision
I. PURPOSE

To establish guidelines for obtaining durable medical equipment and rehabilitative items which are
provided for resale to patients for use after hospital discharge.

II. POLICY

The hospital will obtain for patients, those items which are necessary for rehabilitative purposes, and
which the patients or their families cannot independently procure. In addition, the hospital will make
available for sale or rental, a wide range of home medical items through UW Health-Home Care Services,
Orthotics, Occupational Therapy, Physical Therapy, other service departments or an outside vendor.

III. FORMS

Electronic Purchase Requisition Form
Medicare Certificate of Medical Necessity (CMN) form
Physician signed prescription form
Patient financial responsibility form
Other insurance authorization forms

IV. PROCEDURES
A. Departments will first determine that the item to be obtained for the patient meets medical
necessity for hospital discharge and has a physician order.
B. When needed, Coordinated Care Department staff will contact the patient's insurance company to
determine if the item is approved for reimbursement, if there is a preferred vendor, or if it will be
the patient's responsibility for payment. Coordinated Care Department Staff will obtain verbal
authorization from the patient to permit communication of the patient's insurance information to
the outside vendor.
C. Item will be obtained for patient use by therapist, case manager, social worker, or nurse
contacting an equipment vendor (UW Health Home Care Services or other vendor chosen by the
patient or patient's insurance plan). The vendor will provide the item. The therapist/nurse will
assist the physician with completion of prescription, Certification of Medical Necessity (CMN)
and Prior Authorization documentation if required. It is preferred that the Vendor bill the patient's

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insurance directly. When Prior Authorization is required, the item must not be ordered until prior
authorization has been obtained.
D. When a custom item is requested and the vendor is unable to bill the patient’s insurance plan
directly, the Department will submit a Hospital Electronic Purchase Requisition to include cost
center, expense class, vendor name, requesting party's name, product information, and vendor
price. The Department staff must post a charge to the patient's account for the cost center.
Markup should allow for payer discounts/fee schedules. Chargemaster staff should be contacted
to determine markup amount and charge code. Procurement Services will assign a PO number
and send it to Accounts Payable staff. Accounts Payable staff will pay the invoice once it is
received from the vendor and charge the cost of the item to the appropriate cost center. It is
important that Departmental staff communicate the PO number to the Vendor for ease of
payment.
E. When specific resale or medical items are required, Department staff should enter a note in the
patient's chart documenting the specific item given or ordered for the patient, the rationale and the
vendor.
V. COORDINATION

Senior Management Sponsor: SVP, Chief Nursing Officer & Patient Care Services
Author: Director, Coordinated Care and Home Health

Approval Committee: Administrative Policy & Procedure Committee


SIGNED BY

Ronald Sliwinski
President of University of Wisconsin Hospitals and Chief of Clinical Operations


Revision Detail:

Previous revision: September 2012
Next revision: September 2018