Social Workers and Case Managers: How We Help
Arkansas Medicaid, Medicare, and Private Insurance are tough to maneuver. You have a difficult job in getting your patient’s needs met. At Finnegan Health Services, we understand. We are the expert in medical supplies in Arkansas. We know what kind, how much, and how often your patient’s insurance will cover their medical supplies.
Finnegan Health Services started as Finnegan Pharmacy in Little Rock in 1984. When Medicaid first covered infant diapers, Arkansas Children’s Hospital called us to provide them. Since then, our business decided to help people with the principles of honesty, ease, and integrity. We decided to sell disposable medical supplies, and not equipment, as the best way we could serve our community and state.
While all medical supplies fall under DME to Medicaid, Finnegan only sells the following:
-incontinence diapers, pull-ups, bladder pads, and bed pads;
-urinary catheters and drainage bags;
-colostomy, ileostomy, and urostomy products;
-enteral feeding tubes, pumps, and formulas;
-wound care products (not saline); and
-diabetic supplies (not insulin or insulin syringes).
We also bill Medicaid for bath safety equipment, such as:
-bath and shower seats
-toilet risers, and more.
We also provide bids for Medicaid Waiver for uncovered medical supplies on a case by case basis.
For pediatric patients, the number one requested item is diapers or pull-ups. Full Medicaid covers all incontinence products (not ARKids First, also known as ARKids B). A child must be 3 years old and have a valid medical diagnosis (ICD-10). Be mindful that a valid diagnosis is not failure to potty train or nocturnal enuresis (bedwetting).
Full Arkansas Medicaid will cover $130 worth of incontinence supplies and $250 worth of other medical supplies. This is a month’s worth for most people. Wipes are never covered by Medicaid but Finnegan may be able to provide them, at our own expense, depending on the order. Medicaid does cover vinyl or latex gloves.
ARKids First, also known as ARKids B, covers $125 worth of medical supplies monthly. This does not include incontinence supplies at all.
If the child needs more supplies that Medicaid will allow, an Extension of Benefits is possible with medical records. An Extension of Benefits is not guaranteed.
Medicaid covers nutrition supplies if a child eats or takes medicine by a feeding tube, uses a feeding pump, or uses any kind of formula. The child must be 5 years old for Medicaid to cover the supplies. Before age 5, WIC must cover all the feeding supplies.
There is no dollar limit to how much formula a child may receive. The primary care physician must prescribe the caloric intake and from that, Finnegan figures the case quantity per month. There is a limit of 3,000 calories or 30 units per day.
Children can receive formula until their 21st birthday. These can be oral or tube-fed formulas. After the 21st birthday, Medicaid will only cover tube-feeding products. Medicaid requires medical records every year and a PA (Prior Authorization) every 6 months.
If the child is not tube-fed, Finnegan must have an EPSDT on file. The EPSDT, or well-child exam, is a growth and wellness record. An EPSDT is not necessary for thickener but a prescription is.
Arkansas Medicaid requires several points on each prescription. An MD or DO’s signature is the only signature Medicaid recognizes. APN, RN, or any other signature is not valid for medical supply fulfillment.
Medicaid requires a new prescription every time there is a change for size, quantity, or frequency. The only time they do not is for a flavor change in nutritional supplies.
All of these specific rules are hard to remember. Call Finnegan Health Services today at 1-888-789-6600 and let us answer all of your questions, as well as those of your patients.