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Backup medical equipment is defined as an identical or similar device used to meet the same medical need for the patient but provided for precautionary reasons to deal with an emergency in which the primary equipment malfunctions.
Blue Cross and Blue Shield of Alabama does not pay separately or make an additional payment for backup equipment. The supplier is responsible for ensuring there is an appropriate and acceptable contingency plan to address any emergency situations or mechanical failures of the equipment. The expectation is that an acceptable plan would involve input from the patient and the treating physician, and it would take into account the severity of the patient's condition and time restraints in providing emergency support. This means the supplier is responsible for ensuring that the patient's medical needs for the use of this equipment will be met on a continuous and ongoing basis, and there is a plan to deal with any interruptions in the use of the equipment that would be life threatening to the patient. The plan may be as simple as the supplier furnishing backup equipment. However, we will not pay separately and/or make any additional payment for the backup equipment. If the backup equipment is billed, it will be denied as not being reasonable and necessary.
Last Updated July 2010