WAG 20-19-02: Prior Approval

PM 20-19-02.

1. (Provider) Sends HFS 2240, Equipment Prior Approval Request, to BCHS for:
   • artificial limbs and braces,
   • standard and custom-built wheelchairs,
   • hearing aids,
   • respiratory equipment and aids,
   • oxygen,
   • special beds, firm mattresses or bed boards,
   • custom molded shoes, shoe corrections, shoe braces, and
   • other unusual equipment or items.
2. (Provider) Sends pulmonary function study, physician's order, past treatment, and prognosis for respiratory equipment and oxygen.
3. (LTC Facility) Sends HFS 2210, Medical Equipment/Supplies Invoice, to Bureau of Claims Processing for allowable oxygen charges for residents.
4. (BCHS) Decides on request for prior approval, including if item should be purchased or rented.
5. (BCHS) Sends Family Community Resource Center:
   • HFS 2352, Notice of Decision on Request for Medical Service/Item, and
   • copy of HFS 2240.
6. (FCRC) File HFS 2352 in case record.