General Vendor Questions

1. What are the vendor eligibility requirements?

General Requirements for all AADL vendors:

1. Have a storefront.
2. Be wheelchair accessible in accordance with the Alberta Building Code under the Safety Codes Act.
3. Operate five days per week, seven hours per day as a minimum.
4. Either owner or staff must have a minimum of one-year healthcare related experience.
5. Meet minimum computer system requirements to access AADL online.
6. Carry General Liability Insurance, in accordance with the Alberta Insurance Act, in an amount not less than $2,000,000.00 inclusive per occurrence, insuring against bodily injury, personal injury and property damage including loss of use thereof. Such insurance shall include blanket contractual liability.

For all benchmarked benefits the following criteria apply:

Vendors must:

• stock on site a minimum of two product lines from different manufacturers.
• stock products that are priced at/or below benchmark price that meet AADL’s generic descriptions.
• carry products with a manufacturer’s warranty.
• carry products as per the manufacturer’s instructions.
• be knowledgeable regarding the products and ensure staff have appropriate training.
• ensure that Medical/Surgical benefits are only provided at a maximum of two-month intervals.  Clients who wish to obtain more that a two month supply must receive prior approval from the AADL Program Manager (Medical/Surgical Benefits)
• provide a private wheelchair accessible fitting room where indicated.  The following minimum standards must be met:
• a closing door with a width of 80cm (31.5”).
• turning radius in room of 1.52m (5’).
• wheelchair accessible examining table within a height range of 43.2 to 81.3 cm (17 to 32”).
• if a hallway is required to access the fitting room, it shall have a minimum width of 110cm (43.25”).

a) Bathing and Toileting Aids

• have in stock and on site, a minimum of four (4) catalogue items and a choice of two (2) different manufacturers’ products for each catalogue item.
• provide AADL with the names of the manufacturers you represent.

b) Walking Aids

• have in stock and on site, a minimum of four (4) catalogue items and a choice of two (2) different manufacturers’ products for each catalogue item.
• provide AADL with the names of the manufacturers you represent.

c) Incontinence Supplies (Diapers)

• stock on site a minimum of two (2) different manufacturers' product lines that meet AADL's generic descriptions and absorbency specifications.
• provide AADL with the names of the manufacturers you represent.

d) Catheters

• stock on site a minimum of two (2) different manufacturers' product lines that meet AADL's generic descriptions.
• provide AADL with the names of the manufacturers you represent.

e) Dressings

• stock on site a minimum of two (2) different manufacturers' product lines that meet AADL's generic descriptions.
• provide AADL with the names of the manufacturers you represent.

f) Injection Supplies (Syringes):

• have the capacity to pre-load and /or provide subq/IM injectable medications.
• must have a flume hood as per Alberta Pharmacy Association standards.
• note AADL does not provide syringes for diabetes management.
• provide AADL with the names of the manufacturers you represent.

g) Ostomy/Ileostomy/Urostomy Benefits:

• stock on site a minimum of two (2) different manufacturers' product lines.
• a minimum of one (1) staff member who has successfully completed a training course in measuring and fitting from either Coloplast, Convatec, or Hollister every five (5) years.
• provide AADL with copy of current training certificate with application and contract.
• provide AADL with the names of the manufacturers you represent.

h) Mastectomy Prostheses:

• stock on site a minimum of two (2) different manufacturer's complete product lines.
• a minimum of one (1) staff member who has successfully completed a training course in measuring and fitting from either Airway, Amoena-Coloplast, Paradigm Medical or Camp every five (5) years.
• provide AADL with copy of current fitter’s certificate with application and contract.
• have wheelchair accessible fitting room as per AADL’s standards.
• provide AADL with the names of the manufacturers you represent.

i) Burnscar Garments:

• a minimum of one (1) staff member who has successfully completed a training course in measuring and fitting from either Bioconcepts, Jobst or Valco-Medi every five (5) years.
• provide AADL with a copy of current fitter’s certificate with application and contract.
• have wheelchair accessible fitting room as per AADL’s standards.
• provide AADL with the names of the manufacturers you represent.

j) Custom Made Pressure Garments:

• a minimum of one (1) staff member who has successfully completed a training course in measuring and fitting from either Bioconcepts, Jobst, or Valco-Medi every five (5) years, and:
• agrees to perform fittings between 8:00 a.m. to 11:00 a.m. only
• agrees to conduct a follow-up 3 to 4 weeks after initial fittig
• provide AADL with a copy of current fitter’s certificate with application and contract.
• have a wheelchair accessible fitting room as per AADL’s standards.
• provide AADL with the names of the manufacturers you represent.

k) Pressure Gradient Stockings and Lymphedema Sleeves (Ready Made):

• stock on site a minimum of two (2) different manufacturers' products with:
• a minimum of three (3) sizes (e.g. small, medium and large)
• two (2) pressure ranges (25-30 mm Hg, 30-40 mm Hg)
• a variety of styles (below the knee, above knee)
• pressures above 40 mm Hg and/or pantyhose or chap-style may be ordered in as needed
• have a variety of stocking aids available
• a minimum of one (1) staff member who has successfully completed a training course in measuring and fitting from either Jobst, Sigvaris, Valco-Medi, or Venosan every five (5) years, and:
• agrees to perform fittings between 8:00 a.m. to 11:00 a.m. only
• agrees to conduct a follow-up 3 to 4 weeks after initial fitting
• provide copy of current fitter’s certificate with application and contract.
• have a wheelchair accessible fitting room as per AADL’s standards.
• provide AADL with the names of the manufacturers you represent.

l) Abdominal, Back and/or Hernia Supports

• stock on site a minimum of two (2) different manufacturers' product lines that meet AADL's generic descriptions
• a minimum of one (1) staff member who has successfully completed a training course in measuring and fitting from either Airway or Camp every seven (7) years.
• provide AADL with a copy of current fitter's certificate with application and contract.
• provide AADL with the names of the manufacturers you represent.

m) Large Recyclable Equipment and Wheelchairs

• Large Recyclable Equipment and Wheelchairs are tendered contracts. There are specific time periods in which to apply, and specific criteria to be fulfilled.

n) Wheelchair Cushions and Accessories

• Wheelchair Accessories is a tendered contract. There are specific time periods in which to apply and specific criteria to be fulfilled.

o) Seating

• have a functional working relationship with an interdisciplinary seating services team.
• employ a commercial seating technician and/or adaptive seating technician who meet all AADL training and experience criteria.

p) Respiratory

• must employ Registered Respiratory Therapists who are members in good standing with the College and Association of Respiratory Therapists (CARTA), for the set-up of equipment and assessment of clients.
• be affiliated with a medical gas manufacturer and provide a letter from the manufacturer confirming the affiliation with application.
• provide a copy of current CARTA membership for each employed Registered Respiratory Therapist.
• list of oxygen depots in Alberta.

q) Hearing Aids

• must employ clinical audiologists or hearing aid practitioners who are members in good standing with the Alberta College of Speech-Language Pathologists and Audiologists (ACSLPA), and/or the College of Hearing Aid Practitioners of Alberta (CHAPA).
• have at least one registered Audiologist or Hearing Aid Practitioner who has a minimum of one-year experience dispensing hearing aids.
• provide AADL with a copy of current registration with respective college for each employed registered Audiologist and/or registered Hearing Aid Practitioner with application.
• provide AADL with a copy of a letter of reference confirming a minimum of one-year experience dispensing hearing aids.
• provide AADL with calibration certificates on a yearly basis.

r) Prosthetics and Orthotics

• be a member in good standing with the Canadian Board for Certification of Prosthetists and Orthotists and provide a copy of registration with application.

s) Footwear Benefits

• be a member in good standing with the Pedorthic Association of Canada with the designation of Certified Pedorthic Master Craftsman, Certified Orthopaedic Footwear Specialist, Certified Pedorthic Technician or Pedorthist, or an Orthotist member in good standing with the Canadian Board for Certification of Prosthetists and Orthotists, and provide a copy of registration with application.

t) Artificial Eye Prostheses

• be a registered member in good standing with the Alberta Opticians Association and licensed by the Alberta Opticians Association, or a board certified Ocularist as certified by American Society of Ocularists and in good standing with the American Society of Ocularists and provide a copy of registration with application.

2. What are the training requirements for vendors?

Training, certification and recertification requirements for vendors are contained in the benefit area contracts.

1. Ostomy/Ileostomy/Urostomy Benefits

• A minimum of one (1) staff member who is qualified to provide AADL clients by completion of a training course from either Coloplast, Convatec, or Hollister every five (5) years

2. Mastectomy Prostheses

• A minimum of one (1) staff member who is qualified to measure and fit AADL clients by completion of a fitting course from either Airway, Amoena-Coloplast, Paradigm Medical or Camp every five (5) years.

3. Burnscar Garments

• A minimum of one (1) staff member who is qualified to measure and fit AADL clients by completion of a fitting course from either Bioconcepts, Jobst or Valco-Medi every five (5) years.

4. Custom Made Pressure Garments

• A minimum of one (1) staff member who is qualified to measure and fit AADL clients by completion of a fitting course from either Bioconcepts, Jobst, or Valco-Medi every five (5) years, and:
• agrees to perform fittings between 8:00 a.m. to 11:00 a.m. only
• agrees to conduct a follow-up 3 to 4 weeks after initial fitting

5. Pressure Gradient Stockings and Lymphedema Sleeves (Ready Made)

• A minimum of one (1) staff member who is qualified to measure and fit AADL clients by completion of a fitting course from either Jobst, Sigvaris, Valco-Medi, or Venosan every five (5) years, and
• agrees to perform fittings between 8:00 a.m. to 11:00 a.m. only
• agrees to conduct a follow-up 3 to 4 weeks after initial fitting
• have a variety of stocking aids available

6. Abdominal, Back and/or Hernia Supports

• A minimum of one (1) staff member who is qualified to measure and fit AADL clients by completion of a fitting course from either Airway or Camp every seven (7) years.

7. Seating

• Have a functional working relationship with an interdisciplinary seating services team.
• Employ a commercial seating technician and/or adaptive seating technician who meet all AADL-defined training and experience criteria.

Commercial Seating Technician:

1. The senior commercial seating technician must have a minimum seating experience of 24 client assessments and application of seating systems over a 12-month period. The seating experience is not limited to AADL clients. Senior seating technicians will be indicated in the Seating Suppliers’ Vendor List.
2. A senior seating technician must directly supervise commercial seating technicians with experience of less than 24 clients per year. Exceptions to this standard must have AADL prior approval. Prior approval by AADL will be based on:
• Commercial seating technicians with experience of less than 24 clients per year can provide service for 1 month, and can be extended up to 3 months if the OT/PT team agree and have no concerns. The clinic will inform AADL about this temporary situation.
• The technician must have a good working knowledge of wheelchairs, and wheelchair configuration and adjustment, and a basic working knowledge of seating.
3. All seating technicians must complete the approved manufacturers’ training program in all the specialized seating products on Schedule A of the contractand complete the Commercial Seating Technician’s Qualification Initial Submission.
4. All seating technicians must continue to update manufacturers’ training annually in all seating/wheelchair accessory products.
5. All seating technicians must have minimum of 50 hours/per year of education in seating/wheelchair accessory benefits as documented on the Commercial Seating Technician’s Qualification Annual Update.

Adaptive Seating Technician:

6. The senior adaptive seating technician must have a minimum of 600 hours (75 clients at 8 hours/client) of experience/education in the assessment and application of seating systems. The seating experience is not limited to AADL clients. Exceptions to this standard must have AADL prior approval.
7. Must be knowledgeable about working with various metals, wood, plastics, viscoelastic, gels and polyurethane foams.
8. Knowledge of commercial seating components and systems.
9. Basic knowledge of mobility bases.
10. Have a basic anatomy course.
11. Have a basic biomechanics course.

8. Respiratory

• Must employ Registered Respiratory Therapist who has successfully completed a minimum two-year recognized diploma program and are members in good standing with the College and Association of Respiratory Therapists (CARTA), for the set-up of equipment and assessment of clients.
• Provide a copy of current CARTA membership for each employed Registered Respiratory Therapist.

9. Hearing Aids

• Must employ clinical audiologists or hearing aids practitioners who are members in good standing with the Alberta College of Speech-Language Pathologists and Audiologists (ACSLPA), and/or the College of Hearing Aid Practitioners of Alberta (CHAPA).
• At least one registered Audiologist or Hearing Aid Practitioner must have a minimum of one-year experience dispensing hearing aids.

10. Prosthetics and Orthotics

• Must be a member in good standing with the Canadian Board for Certification of Prosthetists and Orthotists and provide a copy of registration with application.

11. Footwear Benefits

• Must be a member in good standing with the Pedorthic Association of Canada with the designation of Certified Pedorthic Master Craftsman, Certified Orthopaedic Footwear Specialist, Certified Pedorthic Technician or Pedorthist, or an Orthotist member in good standing with the Canadian Board for Certification of Prosthetists and Orthotists, and provide a copy of registration with application.

12. Artificial Eye Prostheses

• Must be a registered as a member in good standing with the Alberta Opticians Association and licensed by the Alberta Opticians Association, or a board certified Ocularist as certified by American Society of Ocularists and in good standing with the American Society of Ocularists and provide a copy of registration with application.

3. Are all Albertans eligible for AADL benefits or are there exceptions?

AADL does not cover clients with First Nations Treaty status, those receiving Workers’ Compensation for the same problem, or those who are funded under Veterans’ Affairs for a preexisting condition.

4. Can I conduct assessments over the phone?

No. Specialty suppliers (vendors) must use e-business after assessing a client and authorizers must assess their clients in person.

5. What is the expiry date for a claim?

Claims must be submitted prior to six months from the service date and any rejections resolved prior to 12 months from the service date. Unresolved claims and unpaid claims which have expired are AADL’s biggest problem. Please note that vendors can print an e-business report that can indicate which claims have been paid and what is outstanding. For claims questions that cannot be resolved through e-business, please call one of AADL's claims clerks using our telephone listing. View it here.

6. If I feel a client can benefit from additional AADL benefits, can I promote them?

No, vendors may not “promote” AADL benefits. If vendors think a client requires additional benefits or changes to their equipment and/or supplies they should refer the client back to an authorizer.

7. Should I advise the client regarding their responsibilities?

Yes. You are responsible to make clients aware of their responsibilities, such as filling out all applicable forms (e.g., satisfaction form or cost-share exemption form).

8. What is the AADL “Complaint Registry”?

The AADL Complaint Registry is available to the public, clients, authorizers, assessors and vendors.

The complaint registry is AADL’s internal complaint mechanism. It incorporates a process to resolve specific types of complaints, and documents who complains, the nature of the complaint, who was designated to investigate the complaint, findings of the inquiry, and action taken.

The Program Analysis and Accountability Unit (PAAU) is responsible for the Complaint Registry within the Health Related Supports Branch, because PAAU is not involved in the daily operations of AADL, AISH or RAMP.

This allows them to meet fairness guidelines, which includes: impartiality, independence, removal of potential bias or conflicts of interest. The Complaint Registry is to be used to improve the AADL Program by providing quality service and fostering improved relationships with all stakeholders.

Complaints must be submitted to AADL on the designated complaint form, also available directly from AADL.

Generally complaints are investigated and findings communicated to the complainant within 45 business days.

9. What is the difference between assessment date, trial date and service date?

The assessment date occurs when client’s eligibility for AADL benefits and need(s) are determined. The service date occurs when client is provided the benefit. The trial date occurs when the equipment is sent out for trial by the client. The vendor can only invoice AADL after the trial is completed and the equipment is chosen.

Example: The client is assessed by the authorizer for i.e. a walker on December 1, 2008. The authorizer should put on the 1250 form an assessment date of December 1, 2008 but this is not always the case. The actual model/style of equipment is yet to be determined. The client will choose a vendor and then the authorizer normally contacts the vendor to arrange for a trial of equipment.

The vendor will deliver/send out the equipment e.g December 2, 2008, they will usually have some type of dated document, e.g. courier slip, delivery slip and they may refer to the date on this document as the trial date - December 2, 2008, this date is not normally used by AADL.

The client and the authorizer will then determine if the equipment is appropriate and should contact the vendor to let them know. Sometimes authorizers do not contact the vendor and simply then send out the 1250 form. Some authorizers will now complete the 1250 form and use the date they confirm that the trial equipment is appropriate as the assessment date i.e. December 8, 2008.

Now the vendor is able to bill for the equipment. Due to problems with vendors submitting claims with service dates (e.g., December 2, 2008) that were prior to the assessment date of December 8, 2008 and then rejected, vendors are instructed as per AADL policy not to bill until they have a copy of the 1250 form.

They can then input the service date as the same date as the assessment date or the date they received notification from the authorizer as long as this date is after the assessment date on the 1250 form.

10. What is benchmark pricing?

Some benefits are described generically, allowing the client and authorizer to choose the benefit or equipment model that best meets the client’s need. AADL sets a price for the benefit group. If the vendor's shelf cost is more, the client pays the extra cost. If it is less, the vendor must bill AADL for the benefit at the lower price.

Example: AADL benchmark price for a walker is $359.00. The vendor shelf price is $459.00, although the vendor does have another walker at the benchmark price. If the client chooses the $459 walker, they would pay the extra $100.00. If the client is cost-sharing, they would also pay 25% of $359.00 for a total of $189.75.

The vendor may choose the selling price of their products, but must offer a choice at the benchmark price.

11. Can I automatically charge an upcharge for a product?

There are two ways to price stock:

• Contracted prices – fixed prices. The vendor must sell at this price for the duration of the contract.
• Benchmarked prices. The vendor may choose the selling price BUT must offer a choice at the benchmark price.

If the client chooses a product that costs more than the benchmark, the client is then responsible for paying the upcharge.

12. How does cost-share work?

Cost-share is based on the client’s family income. If the client’s family income is below a set amount determined each benefit year, they are exempt from cost-share. This can be established using the IVR or e-business. Vendors must charge the client cost share unless the client is cost-share exempt. Once the $500 maximum contribution is reached in a benefit year, AADL will refund overpayment.

Vendors may not ask for the $500 up front from the client. A vendor is only allowed to collect what is being billed and invoiced. Vendors must use the IVR or e-business to check for cost-share status. To be eligible for cost-share exemption status, the low-income, Income Support Program (ISP) or Assured Income for the Severely Handicapped (AISH) client must have lived within Canada for the past 12 months and within Alberta for at least the past three months. The cost-share exemption benefit year is from July 1 to June 30 and is based on the invoice date (not the date of application).

13. Can a vendor initiate a quantity and frequency review (QFR) request?

No. Only an authorizer or a specialty supplier can initiate a QFR.

14. As a vendor, can I bill a client for a mistake I make?

No. Please refer to the AADL General Policies and Procedures. Vendor errors are the financial responsibility of the vendor.

15. What inventory must I keep on hand?

Please review your contract. Inventory requirements are specified on contracts and purchase agreements.

16. How long must I keep physical records?

AADL Policy and Procedures require vendors to keep records for 10 years. After this records can be destroyed. Here are some current best practices for destruction of records. When records are to be disposed of, the vendor must protect confidentiality.

1. Records must be shredded to ensure they cannot be reconstructed, and to prevent unauthorized use or access to the obsolete record.
2. Shredders should cut paper diagonally with strips at least as small as 1.59 cm (5/8”).
3. Materials that resist shredding for example water resistant paper, mylar, or reinforced paper should be handled with a different destruction method.
4. Shredded materials should be disposed of in an environmentally safe manner.
5. Duplicate copies of records (transitory records) containing health information should be kept to a minimum.
6. Once the record’s purpose is fulfilled, only the original copy should be retained. Duplicate records should be shredded.
7. If records are waiting to be destroyed, they must be locked in a secure place to prevent unauthorized access.
8. A log of what records are destroyed, when, how, by who, and who authorized the destruction should be kept for audit purposes.
9. A manager should witness the destruction of records.
10. If shredding is done by a third party service, a certificate of destruction should be obtained once records are destroyed.

Electronic records, containing health information, like diskettes, CDs, or hard drives must also be destroyed according to best practice (e.g., shred or break CDs or diskettes, securely wipe, demagnetize).

17. What is a satellite clinic?

A satellite clinic is a clinic that is not staffed five days a week which means a client cannot access services full time. For example, many hearing vendors will do a once a week, or once a month clinic in remote locations. Another example of a true satellite is a hearing aid vendor who attends a clinic in a nursing home once a month. The satellite clinic does not have a permanent fixed location. In other words, the equipment is moved to the location each time staff is at the clinic. If the actual specialty assessor attends the office on an infrequent basis but there are other employees who staff the office on a full time basis, it is not considered a satellite clinic. A satellite clinic would also not be one that would receive mail or have an actual business address or storefront.