Respiratory cost-share information for AADL vendors

1. Communicating with clients

AADL will not be communicting directly with clients. However, if clients call AADL, we will be responding to their questions, but AADL will not be sending anything directly to the clients. The AADL contracted vendors have direct interaction with the clients and therefore AADL has provided the vendors with a cost-share removal fact sheet to give to their clients, with AADL contact information should they have further questions.

2. Vendors still need to use two consent forms

Both the client declaration form and the client responsibility form are still required. Both forms have been amended to remove references to cost share for respiratory clients. Updated versions of both forms will be available after July 1, 2013.

3. How much AADL pays

AADL will now be paying the maximum allocated funding amount for all respiratory clients regardless of income. However, all upgrade charges are still the responsibility of the client to pay.

4. AADL pays for suction catheters

Suction catheters are a respiratory benefit. The non-respiratory vendor has been informed of the cost-share removal.

5. Veterans Affairs and respiratory benefits

Veterans Affairs used to pay the cost-share amount. Now that there is no cost share, AADL will now be paying the maximum allocated funding amount for all respiratory clients. Upgrades may be covered by Veterans Affairs. Please check with your respiratory vendor.

6. Bi-level positive airway pressure devices are also cost-share exempt

Bi-level positive airway pressure devices are cost-share exempt.

7. Vendors do not need to fill in the cost-share reference number on E-Business

This reference number is no longer used so please refrain from entering this number.

8. Approval process for a bi-level positive airway pressure device is the same

All respiratory processes have remained the same.

9. Submitting claims for services provided prior to July 1 after July 1

Vendors have up to 6 months to submit a claim. If the service date is prior to July 1, the cost-share amount will apply. If the service date is July 1 or after, the cost-share should not be applied.

Claims that include a cost-share amount after July 1, 2013 will be rejected and returned for corrections.

10. Alberta Health Services (AHS)

AHS has been involved in communications and shares information with their respiratory therapists.

11. No billing process change

There is no billing process change

12. Cost-share removal

The cost-share removal applies to all respiratory benefits users.

13. No AADL refunds for any cost-share amounts paid in error

It is the vendorís responsibility to refund the client any cost-share portions paid by clients in error for services rendered after July 1, 2013.