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Medicare Hospital Bed Specialist

 

Medicare

NPI#: 0801270001


Paperwork Requirements (Medicare Billing Code: E0627NU)
  1. Initial Intake
  2. Medicare Card (Part B, Secondary Copayment Insurance)
  3. Dr. Rx
  4. CMN - Certificate of Medical Necessity (#4 Once Standing, does the patient have the ability to ambulate?  Answer Must be Yes!)
  5. NO ASSIGNMENT OF BENEFITS (Check Goes Direct to Customer)
  6. (Protocal for Resolving Complaints)
  7. ABN Advance Beneficiary Notice
  8. Driver Instructions
  9. Delivery Ticket Signed by both Customer & Driver
  10. Equipment Warranty Information Form
  11. Patient Satisfaction Survey
  12. Acknowledgement of Receipt by Patient Form

 

Hospital Bed Medicare

  1. Initial Intake
  2. Medicare Card (Part B, Secondary Copayment Insurance)
  3. Dr. Rx
  4. Chart Notes
  5. Assignment of Benefits
  6. Capped Rental
  7. (Protocol for Resolving Complaints)
  8. ABN Advance Beneficiary Notice
  9. Driver Instructions 
  10. Delivery Ticket Signed by both Customer & Driver
  11. Equipment Warranty Information Form
  12. Patient Satisfaction Survey
  13. Acknowledgement of Receipt by Patient Form

Scooters & Power Wheelchairs

  1. Initial Intake/Measuring Guide
  2. Medicare Card (Part B, Secondary Copayment Insurance)
  3. Authorization For Release of Medical Info
  4. Face to Face, Chart Notes Documenting Face to Face, Last 45 Days
  5. Dr. Rx
  6. (Protocal for Resolving Complaints)
  7. ABN Advance Beneficiary Notice
  8. Driver Instructions: Assesment of Living Area/Home Evaluation (DRIVER CAN DO)
  9. Delivery Ticket Signed by both Customer & Driver
  10. Equipment Warranty Information Form
  11. Patient Satisfaction Survey
  12. Acknowledgement of Receipt by Patient Form


Patient Intake p.df.pdf13.9 KB Patient Intake p.df.pdf13.9 KB Patient Intake p.df.pdf13.9 KB Patient Intake p.df.pdf13.9 KB
CMS849.pdf98.5 KB CMS849.pdf98.5 KB

SPAN AMERICA Support Surface Reimbursement for Homecare

Home > Medicare Specialist

We welcome you into the family of ELECTRIC-PEDIC® Beds, a family owned company since 1964, member of the BBB, and Joint Commission Medically Accredited to answer all your Medical Medicare and Insurance Needs.

We were the first ELECTRIC Home Care Products Company; in fact we invented the industry: Electric Adjustable and Hospital Beds; Electronic Chair & Stair Lifts; Electrical Wheel Chairs and Powerchairs; Motorized Scooters and Wheel Chair Lifts; Powered Massage Chairs and Recliners; Mobility and Handicap Ramps and Wheelchair Elevators and Vertical Platform Lifts.

We realize that COST is always a central factor: the price or prices you have to buy the product for. We offer the best SALE prices in the industry. Whether you are looking for the cheapest or most inexpensive product, or the best and highest quality comfort and mobility in the industry, we are here to always get you the best price on new and used home care equipment.

We are authorized dealers from over 50 different disability and disabled manufacturers and suppliers; and offer over 1001 handicapped homecare models and equipment.







We work with your doctor to fill out all Medicare and insurance paperwork for you. We submit the forms on your behalf and follow up as needed. You pay nothing up front if you have qualified supplemental insurance and have met your deductibles. In fact, you may owe nothing at all.

Contact us for more information about Bariatric Beds and Hospital Beds

Medicare and Medicare Forms