REPAIRS AND MAINTENANCE PROCEDURES

Initial Request:

  1. When taking the call from the client or therapist, ask for the following information:
  2. Client name, address, Health Card number and expiry date
  3. Manufacturer and model of equipment
  4. Details of the problem:
  5. What is the problem? What is broken or not functioning properly?
  6. Is the equipment functional or completely broken?
  7. Has the client anything to use in the interim?
  8. If a therapist is requesting the service call, please include the OT/PT’s name and any written documentation they have provided.
  1. Complete the Health Services claim form to request approval for the service call, providing all of the information obtained from the client or OT/PT in the Additional Information field.
  1. If the request is urgent, please indicate this in the same area of the form provide a reason for the urgency.

NOTE: Urgent requests are defined as meeting all the following conditions:

  1. The client’s current equipment is not functional.
  2. The equipment cannot be used until it is repaired.
  3. The client requires the equipment to function on a daily basis
  4. The client cannot wait until the dealer’s next regular service run.
  5. The client has nothing else that can be used as a replacement, even on a short term basis.
  6. The dealer must travel further than 50 km from their place of business to provide the service to the client.
  1. Submit the approval request to Health Services by fax. You should receive a reply on urgent requests within 24 hours. Non-urgent request will be processed within 1-3 business days. If you do not receive a response by fax within the time frames indicated, send an email to the appropriatehealth services administrator to follow up, including a copy of the outstanding request.

If the appropriate Health Services staff member is out of the office and unavailable to respond within the time frames indicated above, you may send the requests to the Health Services supervisor or acting supervisor, who may assign someone else to process the request.

  1. Should Health Services staff require additional information to process the request, they will email the supplier to request this.
  1. Wheelchair/ Seating equipment: Approval from Health Services for the service call in this component of the program implies approval to repair the issue(s) mentioned in the original submission unless otherwise noted on the approval document. These requests do not need to be resubmitted for a revised approval and may be billed once the service(s) have been completed.

EXCEPTION: If the repair of the original issue(s) means the replacement of any ONEpart with a MSRP exceeding $500, then a revision of the approval must be requested. Proof of MSRP for the part must be included with your request for the revision. Please refer to the “Revisions” section below for details on the revision process.

  1. Convalescent/ Rehab equipment: Approval from Health Services for the service call in this component of the program implies approval to repair the issue(s) mentioned in the original submission unless otherwise noted on the approval document. These requests do not need to be resubmitted for a revised approval and may be billed once the service(s) have been completed.
  1. Once approval has been provided by Health Services, the technician is expected to go to the service call prepared to fix the problem identified by the client and to complete the repair in the most cost effective manner possible on the 1st visit.
  1. Manufacturer’s warranty: Manufacturer’s warranties must always be checked when appropriate, given the age of the equipment and the repair required. Health Services reserves the right to question requests when the possibility of warranty coverage exists and will require justification for any refusals within the warranty periods published on the manufacturers’ websites. If no published warranty information exists, SD will require WRITTEN justification from the manufacturer SPECIFIC to the client and equipment in question.
  1. Technicians are expected to fix the problem in the most cost effective manner possible.
  1. Repairs should be considered before requesting approval for replacement parts.
  2. If the part requiring repair is sealed, then the expectation is that it will be returned to the manufacturer for repair.
  1. Service call fees will be handled as follows:
  1. Only one (1) service call fee can be applied to the repair of a single item where no additional parts need to be ordered. Should the Technician be required to make a second visit because they did not have the general repair supplies necessary to complete the visit, the supplier will not charge a second service call fee but will record it on the claim form submitted.
  2. If a Technician does a service call for a client and it is determined that a part that is not stocked needs to be ordered to repair the equipment, then a second service call may be billed.
  1. Service calls for multiple pieces of equipment for the same client will be handled as follows:
  1. All repairs should be completed on the same day, where feasible, and only one (1) service fee may be applied.
  1. If all repairs cannot be completed on the same day because of scheduling issues, the supplier will not apply two (2) service fees
  1. If a second service visit is required because a part for one piece of equipment needed to be ordered which would delay the repair of the alternate piece(s) of equipment, the supplier will be able to do two (2) separate service calls and bill for both.

Request for Revision to Initial Approvals:

  1. If additional approval is required once the technician has seen the client, the revision request should be submitted on the original claim form within 1-5 business days following the technician’s return to the office.
  1. The original claim form that the initial approval was received on should be revised to include service dates and parts/pricing for the work completed and parts and pricing for the work not yet done. It should also include any updates or additional information on the request that will assist Health Services staff in their assessment of the revision.
  1. Revisions should be flagged by adding “Revised” and the date of the revision to the claim form below the original claim number. Also include the original approval number and the date of original approval in the “Approved” box for Health Services’ reference.
  1. Send to Health Services by fax. Revisions will be reviewed and if approved, will have a signed and dated note next to the original approval number. If refused, the reason will be in indicated on the claim form. If more information is required, the claim form will be emailed to the supplier with the relevant questions.

Suppliers should receive a reply on urgent requests within 24 hours. Non-urgent request will be processed within 1-5 business days. If you do not receive a response within the time frames indicated, please refer to #3 under Initial Requests above.

Payment submissions:

  1. Always use the original Health Services claim form number that approval was received on to bill.
  1. Enter all service dates on the invoice and include a vendor reference number, if desired.
  1. Provide details of the work completed in the Additional Information section. If the space is insufficient, include another piece of paper.
  1. Include the original health services green form, the supplier invoice (if desired) andpacking slip signed by the client or therapist.

5.Mail to Health Services within 30 days of the completion of the work.

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