Medicare Enteral Qualification Checklist
Medicare Enteral Qualification Checklist
General Items
- Review Medicare guidelines for enteral nutrition.
- Ensure all forms are filled out completely and accurately.
- Schedule follow-up appointments to monitor patient's progress.
Patient Eligibility
- Confirm patient has a medical need for enteral nutrition.
- Verify patient is enrolled in Medicare.
- Check for physician's order specifying enteral nutrition.
- Ensure patient has a diagnosis that warrants enteral feeding.
Documentation Requirements
- Obtain detailed medical history.
- Collect relevant lab results and assessments.
- Ensure documentation includes weight history.
- Document attempts to use oral feeding if applicable.
- Include any previous nutrition interventions tried.
Insurance Coverage Criteria
- Verify coverage for enteral nutrition under Medicare.
- Check for coverage of specific enteral formulas.
- Confirm that the quantity of formula meets Medicare guidelines.
Supplier Requirements
- Ensure supplier is a Medicare-approved provider.
- Confirm supplier can deliver enteral products as needed.
- Check supplier’s ability to provide necessary education for usage.
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