WAIVERS

For new set ups/replacements requiring compliance:

-All Blue Cross policies and Medicare Plus Blue: BCBS CPAP Patient Letter 1/1/16
-If it won’t attach for some out of state plans, let Molly or Craig know and they can fix it.
-All Northwood plans (including Advantage and BC Complete): Northwood BCNPatient Letter Waiver
-Anyone else*: CPAP: Insurance Waiver-CPAP-MHM – Ver 2
BIPAP: InsuranceWaiver_BiPAP-MHM
BIPAP ST/ASV: InsuranceWaiver_BiPAPST-MHM

*No waiver for Medicare part B Primary, Meridian CPAPs, Aetna, or any insurance with no compliance

ALL NEW SET UPS need 3-4 docs attached:
Delivery ticket
PAP orientation sheet
Initial Care Plan/Care Plan Update
Appropriate waiver, if needed.

For mask refits/anything else where waiver is required:

-All Northwood plans (including Advantage and BC Complete): BCN Blank Waiver-2016
-Medicare Part B: Medicare ABN
-Anyone else: Insurance Waiver_Blank-MHM

*Fill in all the information for clinicians – item type, price, reason, etc.

ALL APPOINTMENTS need 2-3 documents attached:
Delivery Ticket
Care Plan Update
Appropriate waiver, if needed