SMS Funding and Documentation 3

Question 1

Which of the following best describes the role of the ATP in the funding process for complex rehab technology (CRT)?

Accepted Answer

The ATP performs the evaluation, documents functional need, and recommends appropriate equipment to support the physician's order

Answer

The ATP (Assistive Technology Professional) evaluates the client, documents their needs and functional abilities, and recommends appropriate equipment, which the physician then prescribes.

Question 2

Medicaid coverage for seating and mobility equipment in the US is primarily determined by:

Accepted Answer

Each state's individual Medicaid program, which can vary significantly

Answer

Medicaid is a joint federal-state program, and each state sets its own coverage policies, so coverage for seating and mobility equipment varies by state.

Question 3

What is 'competitive bidding' as it applies to DMEPOS suppliers?

Accepted Answer

A CMS program where suppliers in certain areas bid for the right to supply specific DME categories, with CMS setting reimbursement rates based on bids

Answer

CMS's DMEPOS Competitive Bidding Program establishes contract suppliers in designated geographic areas, with reimbursement rates set based on submitted bids.

Question 4

A 'Certificate of Medical Necessity' (CMN) is most associated with which type of DME?

Accepted Answer

Oxygen equipment

Answer

CMNs are specifically required for oxygen and certain other DME categories; power wheelchairs use a written order and detailed documentation rather than a CMN form.

Question 5

When a payer requests a 'peer review' of a wheelchair claim, this means:

Accepted Answer

A physician or clinician hired by the payer reviews the clinical documentation to determine medical necessity

Answer

Peer review is a process where the payer engages a clinical reviewer to evaluate the submitted documentation and determine if medical necessity criteria are met.

SMS - Certified Seating and Mobility Specialist Practice Test

SMS - Certified Seating and Mobility Specialist Practice Test

SMS Funding and Documentation 3