Description Durable Medical Equipment (DME) is medical equipment prescribed by a physician that meets each of the following requirements. Durable medical equipment (DME) coverage. It is best to think of Medicare’s durable medical equipment coverage as having 2 levels. The equipment must be vital to your daily life, like an oxygen tank or blood sugar tests for diabetics, and not just for your comfort — like a humidifier or air purifier. Biofeedback (only covered for spastic torticollis, headache or pediatric urinary incontinence), Experimental and investigation treatments, Extended Cardiac Rhythm Monitoring (External and Implanted Cardiac Monitors/Loop Records). Durable medical equipment, such as wheelchairs, scooters, walkers and … Dean Advantage. Durable medical equipment 50% coinsurance Not covered Purchase of DME with a per unit cost of $500 or more (except for hearing aids) and all DME rentals must be Prior Authorized. Types of DME Covered by Medicare. Durable medical equipment fraud is one of the leading ways criminals commit health care fraud. Blood sugar test strips. Quartz-branded health plans are offered by Quartz Health Benefit Plans Corporation, Quartz Health Plan Corporation, Quartz Health Plan MN Corporation and Quartz Health Insurance Corporation, which are separate legal entities. Home Health Care including home infusion services and other in-home therapy services, Outpatient High Tech Radiology Services (ETF Only)*, Abortions including multi-fetal reductions, Endoscopic procedures for Reflux Management ​(LINX), Laser re-surfacing for non-cosmetic procedures (, Laser treatment of actinic keratosis or other benign skin lesions, Left Ventricular Assist Devices (LVAD) for Treatment of Heart Failure ​, Orthopedic Procedures Including Artificial Cervical and Lumbar Disc Surgery, OATS Procedures and Hip Resurfacing, POEM (peroral endoscopic myotomy) Procedure, Removal of port wine stains and hemangiomas, Scar revision and repair (cosmetic procedures are excluded), Temporomandibular Joint Disease surgical treatment, Transperineal placement of biodegradable material (SpaceOar), Transplants including donor and other related charges (excludes corneal except for artificial corneal transplants), Surgical Treatment of Obstructive Sleep Apnea, Varicose Vein or Spider Vein Procedures including Sclerotherapy, Radiofrequency Ablation, Vein Stripping and Ligation. Though your doctor may suggest that home modifications may help due to your medical condition, Medicare does not include coverage for them under its durable medical equipment (DME) benefit. Is prescribed for a defined medical purpose 2. Chartwell Health Resources coordinates Durable Medical Equipment (DME) services on behalf of Quartz. Learn more about plan monthly cost,premimum deductibles,prescription drug coverage, hospital services, accepted doctors and more. Prior authorization may be required. Dr. Jessica Solky Butzel is a Psychologist - Clinical based out of Cape Elizabeth, Maine and her medical specialization is Psychologist - Clinical.She practices in Cape Elizabeth, Maine and has the professional credentials of PH.D..The NPI Number for Dr. Jessica Solky Butzel is 1174745814 and she holds a License No. Get Health Insurance plan info on Quartz Prime Gold I401 from Quartz. Quartz-branded health plans are offered by Quartz Health Benefit Plans Corporation, Quartz Health Plan Corporation, Quartz Health Plan MN Corporation and Quartz Health Insurance Corporation, which are separate legal entities. Coverage for --Hearing Aids: Limited to one per ear every 36 months. Most standard insurance packages exclude coverage from incidents resulting from the service of medical equipment. Quartz Medicare Advantage works with Medicare to provide significant coverage beyond Part A and Part B benefits. 1. Durable medical equipment 50% coinsurance after deductible Not Covered Coverage for --Hearing Aids: Limited to one per ear every 36 months. Our team coordinates care through a region-wide system of providers credentialed by CHR. Room 1201 Practitioners must submit a prior authorization request via My Quartz Tools or fax a Medication Coverage Request Form to Quartz at (888) 450-4711. Providers are encouraged to review the Prior Authorization List frequently for changes. For copies of Medical Policies specific to your plan, please contact Medical Management at (866) 884-4601. Common Insurance Terms; Lyft rides. Experimental and Investigational Treatments Genetic Testing including Pharmacogenetics Testing Prosthetics, including upper extremity, lower extremity, eye, face, etc. Her current practice location address is 60 Edgewood Rd, , Cape Elizabeth, Maine and … Contact Information. Fax: (608) 203-2250 . Suite 102. © 2020 Quartz Health Solutions, Inc. All rights reserved. DME that Medicare covers includes, but isn't limited to: Blood sugar monitors. Some DME's purchase directly from our distributors. When you Choose Self-Funded, Choose Quartz. Medicare also does not cover assistive devices, such as large-button telephones or flashing … Is determined by Medica … Get Health Insurance plan info on Quartz One Bronze I202 from Quartz. When you Choose Self-Funded, Choose Quartz. DURABLE MEDICAL EQUIPMENT & DISPOSABLE MEDICAL SUPPLIES Foot pads, bunion covers, batteries, antiseptics, tape, over-the-counter shoe inserts, supports and elastic bandages; ... Quartz Health Insurance Corporation, Quartz Health Plan Corporation, and Quartz Health Plan MN Corporation. All genetic testing including pharmacogenetics, tumor marker, whole genome and whole exome testing. Medicare Part B (Medical Insurance) covers Medically necessary durable medical equipment (DME) if your doctor prescribes it for use in your home. © 2020 Quartz Health Solutions, Inc. All rights reserved. Learn more about plan monthly cost,premimum deductibles,prescription drug coverage, hospital services, accepted doctors and more. Middleton, WI 53562 (608) 203-2273. Get Health Insurance plan info on Quartz One Bronze I201 from Quartz. (800) 730-8555 Chartwell Health Resources (CHR) provides medical management and care coordination of home health, home infusion and respiratory therapy/durable medical equipment (RT/DME) services for Quartz. Contact Chartwell at (608) 831-8555 or (800) 730-8555 for your DME needs Medical Policies are the property of Quartz Health Solutions, Inc. The following Prior Authorization List is not an all-inclusive list and will be updated on a periodic basis. Medicare never covers home modifications, such as ramps or widened doors for improving wheelchair access. Thus, if one has Medicare Part C, their plan will pay at least 80% of the allowable limit for durable medical equipment. Different medical equipment may have different coverage restrictions Durable medical equipment (DME) is a device or tool that is medically necessary for a patient. Durable Medical Equipment Chartwell Health Resources coordinates Durable Medical Equipment (DME) services on behalf of Quartz. Durable medical equipment (e.g., wheelchairs, oxygen) 20% coinsurance per item Prosthetics (e.g., braces, artificial limbs) 20% coinsurance per item Diabetes supplies $0 copay (Not all Durable Medical Equipment companies (DME's) that carry our products choose to be listed on our website. For more information, see our. You can purchase DME from a variety of places, but you should consult with your physician and insurance company before making a final decision. Durable Medical Equipment (DME) and Insurance Coverage Durable Medical Equipment is categorized as any medical equipment for home use that is reusable and for long-term use. Department of Health Services (DHS) Contacts, BadgerCare Plus - Member Rights & Responsibilities, Individual Network Health Insurance Wisconsin. Medicare Part B (Medical Insurance) covers power-operated vehicles (scooters) and manual wheelchairs as durable medical equipment (DME) that your doctor prescribes for use in your home.. You must have a face-to-face examination and a written prescription from a doctor or other treating provider before Medicare helps pay for a power wheelchair. ... DME equipment rental, replacement, repair, upgrade or purchase; ... by Quartz Health Benefit Plans Corporation, Quartz Health Plan Corporation, Quartz Health Plan MN Corporation and Quartz Health Insurance Corporation, which are separate legal entities. Unauthorized use and distribution of these Medical Policies is strictly prohibited. Medicare First Tier, Downstream and Related Entitles (FDR) Compliance, Provider Communicator Newsletter & News Flash Bulletins, Custom shoes and custom-molded foot orthotics (limited benefit) includes orthopedic shoes, DME equipment rental, replacement, repair, upgrade or purchase, Dynamic Orthotic Cranioplasty (DOC) bands, Electric Tumor Treatment Fields (TTF) Device (Optune®) ​. DME costs include repair, buy, or equipment rental. It is required by law to provide, at a minimum, the same coverage as Part A and Part B. Medical Event Services You May Need What You Will Pay Limitations, Exceptions, & Other Important Information In Network (You will pay the least) Out of Network (You will pay the most) Durable medical equipment No charge after deductible Not Covered Coverage for --Hearing Aids: Limited to one per ear every 36 months. Disposable medical supplies such as gloves, injection needles, blood testing strips, catheters, incontinence products, etc., that are typically only used once and then disposed of. To obtain the list of covered hearing aid models log onto www.QuartzBenefits.com/hearingaids or contact Customer Service. For more information, see our. If you sell, service, or repair medical equipment, you may be held legally liable for bodily injury, death, or property damage that results after you serviced the equipment. Behavioral Health Resources Inc. (BEHAVIORAL HEALTH RESOURCES INC.) is a Psychological Services Center (Psychologist) in Cape Elizabeth, Maine.The NPI Number for Behavioral Health Resources Inc. is 1861464380. They do so by filing false insurance claims with Medicare or your insurance company. Fractional flow reserve calculation after coronary CT angiography (FFR-CT). Medicare First Tier, Downstream and Related Entitles (FDR) Compliance, Provider Communicator Newsletter & News Flash Bulletins. Information and forms. Medical Injectables. Non-covered durable medical equipment & supplies. This plan includes additional Medicare prescription drug (Part-D) coverage. Durable medical equipment (e.g., wheelchairs, oxygen) 10% coinsurance per item Prosthetics (e.g., braces, artificial limbs) 10% coinsurance per item Diabetes supplies $0 copay Prior authorization is not a guarantee of payment. See www.QuartzBenefits.com/WIPAList or call Customer To obtain the list of covered hearing aid models log onto To obtain the list of covered hearing aid models log onto www.QuartzBenefits.com/hearingaids or contact Customer Service. Shop Medicare Plans Shop Employer Group Plans ... Medical Management; Dean Health Plan medical management ... Medical prior authorization service list. Learn more about plan monthly cost,premimum deductibles,prescription drug coverage, hospital services, accepted doctors and more. Elective hospital admissions require prior authorization before admission and notification when admitted. If you decide to sign up for Aurora Health Quartz Med Advantage Core D (w/Rx) (HMO) you still retain Original Medicare. The current location address for Behavioral Health Resources Inc. is 1000 Shore Rd, Bldg #326, Cape Elizabeth, Maine and the contact number is 207-799-9006 and fax number is 207-767-6595. PE 1398 (Maine). Prior Authorization List for Medical Services. Non-covered services. Please contact Quartz Customer Service at: (800) 362.3310 with specific code information to determine if an item or service requires prior authorization. Prior authorization is required for clinic-administered medications. Durable medical equipment 30% coinsurance after deductible Not Covered Coverage for --Hearing Aids: Limited to one per ear every 36 months. AncoTek: Medical Equipment Insurance. See www.QuartzBenefits.com/WIPAList or call Customer Durable medical equipment (e.g., wheelchairs, oxygen) 15% coinsurance per item Prosthetics (e.g., braces, artificial limbs) 15% coinsurance … 5249 East Terrace Drive. General Liability Insurance Includes: Premises Liability - If you run a retail establishment for your medical equipment supply store, there is a risk that a customer can come to harm while they’re there. East Branch Location. Note: Urgent / emergent hospital admissions require notification at the time of admission. If a customer falls in the bathroom for example, because the handicapped bar could not support their weight, they may require medical attention. *UW Health and UnityPoint Health – Meriter Clinics are exempt from prior authorization for High Tech Radiology Services. Prior authorization may be required. The Aurora Health Quartz Med Advantage Value D (w/Rx) (HMO) has a monthly premium of $31.00 and has an in-network Maximum … In short, durable medical equipment is any long-term reusable device that provides therapeutic benefits to patients due to a medical condition or illness. PS1160 (Maine). Jayne Boulos is a Psychologist - School based out of Cape Elizabeth, Maine and her medical specialization is Psychologist - School.She practices in Cape Elizabeth, Maine and has the professional credentials of LPE.The NPI Number for Jayne Boulos is 1861892671 and she holds a License No. If you have any questions about the prior authorization list or want to know if a service or supply requires prior authorization, please contact Customer Service through the message center within My Quartz Tools for providers or MyChart for members or call (800) 362-3310. Learn more about plan monthly cost,premimum deductibles,prescription drug coverage, hospital services, accepted doctors and more. Get Health Insurance plan info on ProHealth Gold HSA 3000 from Quartz. Canes. Department of Health Services (DHS) Contacts, BadgerCare Plus - Member Rights & Responsibilities, Individual Network Health Insurance Wisconsin. 1345 Deming Way. For more information, see our Companies and Licenses page. Quartz-branded health plans are offered by Quartz Health Benefit Plans Corporation, Quartz Health Plan Corporation, Quartz Health Plan MN Corporation and Quartz Health Insurance Corporation, which are separate legal entities. These companies are separate legal entities. providers to obtain needed medical advice, care and treatment. Durable Medical Equipment All DME-related costs of $500 or more require PA. DME costs of less than $500 do not need a PA if the KX modifier is used on the claim. Aurora Health Quartz Med Advantage Value D (w/Rx) (HMO) H5262-011 is a 2021 Medicare Advantage Plan or Medicare Part-C plan by Quartz Medicare Advantage available to residents in Wisconsin. The following procedures must be prior authorized before they are scheduled. Of providers credentialed by CHR providers credentialed by CHR use and distribution of these Medical Policies is strictly prohibited Health! 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