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CERTIFICATION OF MEDICAL NECESSITY FOR INFUSION PUMP (Manufacturers invoice must be attached) Request Type: Rental Purchase (length of need greater than 10 months)Certification Type/Date: INITIAL
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To fill out chapter 5160-10 medical supplies, follow these steps:
02
Begin by filling out the heading information, such as the provider name, address, and NPI number.
03
Next, provide the recipient information, including their name, date of birth, and Medicaid ID number.
04
Specify the type of medical supply being requested and the quantity needed.
05
Indicate the diagnosis or medical condition that requires the use of the requested supply.
06
Mention any specific instructions or additional information that may be relevant.
07
Sign and date the form to certify its accuracy.

Who needs chapter 5160-10 medical supplies?

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Several individuals and healthcare providers may require chapter 5160-10 medical supplies, such as:
02
- Medicaid recipients who have a diagnosed medical need for the supplies.
03
- Healthcare professionals who prescribe or provide care for Medicaid beneficiaries.
04
- Durable Medical Equipment providers who furnish the supplies.
05
These supplies are typically used for therapeutic purposes, medical treatment, or managing medical conditions.
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Chapter 5160-10 pertains to the regulations and guidelines governing the provision and coverage of medical supplies under specific healthcare programs.
Providers of medical supplies and equipment who participate in certain healthcare programs are required to file under chapter 5160-10.
Filling out chapter 5160-10 requires providers to complete specific forms documenting the medical supplies provided, including details like quantity, description, and patient information.
The purpose of chapter 5160-10 is to ensure proper documentation and accountability for the provision of medical supplies, ensuring patients receive necessary items covered by their healthcare plan.
Providers must report information such as the patient's identification, the specific medical supplies provided, billing codes, and dates of service.
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