Glossary: funding, resupply and equipment terms.

An approved price is the price a funding programme sets for a device, which is not the price a clinic charges for it. Ontario's Assistive Devices Program defines an Approved Price as the price listed in the programme's own product manuals or policy and administration manuals, and under its fixed price model it pays 75% of that figure rather than a share of your invoice. In norvelle a payer's coverage rule can be a percentage of a named base, which is how a programme share of an approved price is carried on an invoice with more than one payer.

The Assistive Devices Program (ADP) is the Ontario Ministry of Health programme that helps people with long-term physical disabilities pay for equipment and supplies; it is a provincial health programme, and not the payroll company that shares those three letters. For respiratory equipment it pays 75% of its approved price directly to the business that sold the equipment and the client pays the other 25% to that same business, except that the programme pays 100% of the approved price where the client receives Ontario Works, the Ontario Disability Support Program or Assistance for Children with Severe Disabilities. What the model does to a vendor's invoice is set out on Assistive Devices Program (ADP) billing for CPAP clinics.

An authorizer is an individual registered with Ontario's Assistive Devices Program to perform assessments on people who would like to apply to the programme for funding assistance for a device. Respiratory equipment is assessed differently: the examination is done by a doctor or a nurse practitioner, and a continuous, auto-titrating or bi-level positive airway pressure system calls for a doctor at a sleep clinic registered with the programme. The roles sit side by side on Assistive Devices Program (ADP) billing for CPAP clinics.

A co-pay is the part of an invoice the patient pays themselves once every payer share has been applied; the Interim Federal Health Program, for one, calls the 30% a client pays the provider for supplemental benefits a co-payment. In norvelle the patient's portion is what is left after each payer's coverage rule has run, worked out rather than typed, and a resupply plan applies it to every invoice it raises. The two ways to take one are on auto resupply.

CPAP stands for continuous positive airway pressure, the therapy that holds the airway open with a steady flow of air through a hose and a mask. Ontario's Assistive Devices Program funds it as one of three positive airway pressure systems, beside auto-titrating (APAP) and bi-level (BPAP) systems, and does not fund replacement masks or headgear for CPAP machines, which is why resupply is billed privately or to the patient. In Québec French the therapy is PPC. The clinic side of it is on CPAP clinic software for Canadian clinics.

HME is home medical equipment: the trade term for equipment a vendor supplies to a patient at home rather than to a hospital, such as positive airway pressure machines, oxygen concentrators, masks, tubing and filters. An HME vendor is usually billing more than one payer for a single delivery and resupplying the consumable parts on a schedule afterwards, which is the work covered by funding programmes and payer billing and auto resupply.

The Interim Federal Health Program (IFHP) gives limited and temporary health care coverage to resettled refugees, refugee claimants and certain other groups until they are eligible for provincial or territorial insurance. Medical supplies and equipment sit in its supplemental coverage, where the programme pays 70% of the eligible cost and the client pays the other 30% to the provider as a co-payment; only a provider registered with the programme can be paid, and Medavie Blue Cross administers it. The clinic's side is on Veterans Affairs Canada and the Interim Federal Health Program.

Non-Insured Health Benefits (NIHB) is the Indigenous Services Canada programme that covers health benefits for eligible First Nations and Inuit clients where they are not covered by a provincial, territorial, private or other publicly funded plan. For medical supplies and equipment an item has to be prescribed by an NIHB-recognized prescriber and obtained from an NIHB-recognized provider; many items are covered directly, while certain requests are reviewed by the regional office before a coverage decision is made, and Express Scripts Canada processes claims and payment so that providers bill the programme rather than the client. What the clinic records is on Non-Insured Health Benefits (NIHB) on the invoice.

The payer directory is norvelle's list of the funding programmes and insurers a clinic bills, each held with its type, its coverage rule, whether an approval or claim reference is required on a share, and which clinics can see it. A coverage rule is a percentage of a named base or a fixed amount, and it applies every time that payer is added to an invoice. The directory starts with 22 Canadian payers; the Assistive Devices Program is the one whose coverage rule ships set up, and every other payer's rule is entered once by the clinic. It is described in full on funding programmes and payer billing.

POC 9 is Program of Choice 9, the Veterans Affairs Canada treatment benefit for oxygen therapy and respiratory equipment, and its items include oxygen concentrators, oxygen compressors, oxygen gas, continuous positive airway pressure (CPAP) machines, automatic positive airway pressure (APAP) machines, bilevel positive airway pressure (BiPAP) machines and ventilators. What the department may pay is set under the Veterans Health Care Regulations and listed in the published benefit grids, and a claim is to be submitted within 18 months of the day the expense was incurred. See Veterans Affairs Canada and the Interim Federal Health Program.

A registered vendor, in Assistive Devices Program terms, is any person or entity that has met all of the programme's registration requirements and holds an executed Vendor Agreement with it. Registration attaches to a business location, which the province gives a vendor registration number; the programme's stated target for reviewing an application is six months from the date it receives everything required, and a registered vendor has to tell the programme within 10 days of a change such as adding or removing a device category or moving a location. What a registered vendor's invoice has to carry is on Assistive Devices Program (ADP) billing for CPAP clinics.

Resupply is the repeat supply of the parts of a therapy that wear out, such as masks, cushions, filters, tubing and water chambers, sold on a schedule rather than when the patient thinks to call. In norvelle a resupply plan is set up once and raises its own invoice every 3, 6 or 12 months, applies the co-pay, and charges the card or bank account on file. See auto resupply, and the CPAP replacement clock for where the dates come from.