Rehab and Mobility Systems ad reviewed the admission package with me and specifically reviewed and left me a copy of the following information:
HIPPA/Release of information
Privacy policies (and contact information for complaints)
Rights & Responsibilites
Medicare Supplier Standards, if applicable
Home Safety & Emergency Preparedness
Safety / Functionality of the Equipment
Demonstrated Proper Use of Equipment
Warranty Information, if Applicable
Important Telephone Numbers / After Hours Number
EQUIPMENT WARRANTY INFORMATION: Every product sold or rented by our company carries a manufacturer’s warranty. We Will notify all Medicare beneficiaries of the warranty coverage, and we will honor all warranties under applicable law.
We Will repair or replace, free of charge, Medicare covered equipment that is under warranty.
In addition, an owner’s manual with warranty information will be provided to beneficiaries for all durable medical equipment where this manual is available.
I authorize any holder of medical or other information about me to release to the Social Security Administration, Accrediting Agencies, CMS or its intermediates or its Carrier(s) any information needed for this or a related medical insurance benefits. I permit a copy of this authorization to be used in place of the original and request payment of medical insurance either to myself of the party who accepts assignment.