AADL vendor application

To become an Alberta Aids to Daily Living (AADL) approved vendor, you must apply and complete E-Business training

E-Business training and use

About the AADL E-Business application

AADL E-Business is a web application that gives vendors the ability to perform a number of tasks based on security permissions. E-Business is used to:

  • access current AADL policies and program changes, including Bulletins and other communications
  • view client information, including the client’s cost-share status and when AADL benefits were last received (excluding consumables)
  • submit claims on-line and inquire on the status of claims
  • specialty vendors can submit and update authorizations on-line and inquire on the status of authorizations
  • specialty vendors can add a client to E-Business
  • all vendors can view authorizations and update client information

E-Business training videos

AADL E-Business training videos are for vendors and their staff:

Using E-Business

Hours of availability for the AADL E-Business site

E-Business is available from 7:30 am to 5:30 pm Monday through Saturday including government holidays.

Fix a mistake on a claim

You cannot correct the claim online. Do not create a new claim.

Wait for your claim rejection to come in the mail, correct the claim and send it back to AADL for reprocessing.

When to dispense the benefit requested

Once you receive an AADL confirmed authorization through E-Business. Any benefits dispensed prior to receiving confirmation will be the financial responsibility of the vendor.

Correct a cost-share claim that should be cost share exempt

If you have submitted a claim indicating that the client is cost share, AADL assumes the vendor has collected the cost-share portion from the client. AADL will issue a refund to the client.

Get a previous vendor’s product dispensing information

Call the AADL Benefit Clerk for that benefit area. They will check the benefit history and the quantity the previous vendor dispensed so you will know how much product to supply.

Previous products issued to a client

Under the Inquiry, PHN/catalog you can find out the client's previous consumption for non-consumable benefits. If it is a consumable benefit, please contact the AADL Benefit Clerk for that benefit area.

E-Business reports

You can generate reports about claims, authorizations and other reports related to the benefits provided through the AADL program.

The following reports are available:

  • Authorizations in Suspense
  • Open Authorizations
  • Vendor Claims Accepted/Paid
  • Vendor Claim Inquiry by Day
  • Vendor Claim Inquiry by Week
  • Authorizations Created by Day
  • Authorizations Created by Week

Change of vendor

Client process to change vendor

Clients who wish to change vendors should complete and submit the change of vendor form (PDF, 158 KB)

Vendor changes are not accepted over the phone. The client may go to the old vendor or their new vendor to complete the change form. The completed change form must be sent by mail to the AADL program.

A client will be required to obtain these supplies from their old vendor until the next change occurs. Vendor changes for incontinence supplies occurs January 1, March 1, May 1, July 1, September 1, and November 1.

Medical and surgical

Pricing for medical and surgical products

The pricing for medical surgical benefits is based on the benchmarking principle. Each price is based on a specific manufacturer product‘s retail price for the smallest quantity that the vendor has to buy.

Each vendor signs their agreement which states that they will provide clients with choice of product at shelf price, sale price, or benchmark price whichever one is lower. This gives the client choice of product and the vendor choice of different brands provided that they meet AADL generic description for that particular product.

Client products at or below the benchmark price

As an AADL vendor you must offer clients products at or below benchmark price, sale price or shelf price whichever one is lower.

Follow manufacturers' expiry dates for medical/surgical products

Expiry dates are on items for the supplier and consumer’s safety. For example, if you provide the client with outdated flanges for their stoma and an adverse reaction occurs, as the supplier, you could be held liable.

No automatic deliveries to the client

A client or legal guardian needs to call the vendor every 2 months if they require more supplies.

Quantities

2-month AADL medical and surgical supply

AADL’s benefit year starts July 1, if the client gets their 2-month supply on July 1 for July and August and they come back the beginning of August wanting their 2-month supply for September to October, it cannot be supplied until September.

AADL’s maximum quantities are based on best practice and research. These quantities are reviewed on an annual basis. If the client requests more supplies, they need to have a reassessment done by a healthcare professional.

The healthcare professional may suggest trying an alternate product or if applicable, review client technique when using the product. Once the client has been reassessed and all other strategies have been reviewed, the Quantity and Frequency Review (QFR) process can be used provided the authorizer clinically supports the client’s request.

If the client declines a reassessment or does not wish to follow their authorizer’s clinical directions, they are 100% financially responsible for any quantities above the authorized two-month amount (medical/surgical only).

Additional supplies for clients leaving the country

Have the client complete the AADL Request for Advanced Quantities of Medical Surgical Supplies (PDF, 42 KB).

The form must be mailed by the client to AADL at least one month before their departure date. This allows for processing and to ensure that the vendor can provide adequate supplies for the client’s trip.

If approval is given, AADL will contact your store and grant permission to provide the client with a greater than 2-month supply.

Diabetic management

Clients cannot be authorized for syringes for diabetic management. Direct clients to the diabetic supplies information page or their private insurer.

Compression stockings

Funding for compression stockings

The AADL program provides funding for support stockings for specific medical conditions based on a medical assessment of need. To be eligible for coverage of compression garments through AADL, a client must have signs and symptoms of Chronic Venous Insufficiency CEAP 4 or 5 (with hemosiderin staining) or Chronic Lymphedema.

Provide compression garments to clients

AADL has observed that vendors are providing initial clients with all 3 pairs of compression at once. It is strongly advised that clients ONLY receive one pair initially to determine: compliance, adequacy of compression (especially important when a lower leg ulcer has just closed), and the length of garment meets the client’s needs.

If all 3 pairs are provided at once, the client will be responsible for the cost of any stockings that may be required if the original compression authorized does not meet the client’s clinical needs.

Requests for all three compression garments at once

For clients who want all 3 compression garments at once, it is recommended that you have the client sign the AADL’s fitter’s form acknowledging that you recommended that they should take one pair initially.

This protects you if, for example, the client comes back and states they are the wrong length or wrong pressure. You have proof that it was recommended that the client only takes one pair, and the client must pay for any new pairs.

Trying on compression stockings

A client might refuse to try to don and doff their compression stockings independently during the fitting. It is recommended that you document this on the AADL’s fitter’s form and you have the client sign it.

Refusing to be re-measured

A returning client might refuse to be re-measured. Document this on the AADL’s fitter’s form and have the client sign it stating that they declined re-measuring. This will protect you if any concerns or problems arise.

Pantyhose compression stockings

Clients wanting pantyhose but only authorized for below-the-knee compression stockings can pay the additional charges for the pantyhose length. You would bill AADL the compression code that the client is authorized for and then the client would be responsible for any cost sharing and the additional charges, such as the up-grade cost to pantyhose. It is also recommended that this is documented on the fitter’s form.

Breast prosthesis

Eligibility for breast prosthesis clients

As per the AADL Regulation, clients must access all other resources including private insurance. If the client does not have private insurance or any other source of funding, they may be eligible for AADL benefits.

Refusing to go through AADL for funding

You should explain that AADL will not reimburse. This means that if their insurance carrier denies their claim, the client will be 100% responsible for the cost of the breast prosthesis.

Swimmer prostheses/mastectomy bras

AADL does not cover swimmer prostheses/mastectomy bras. The client may want to check with their private insurer for coverage for these items.

Incontinence supplies

Pull-up style of diaper under the AADL diaper code

You can provide a client with a pull-up style of diaper, provided it meets AADL’s absorbency standards.

Children's swimmer diapers not covered by AADL

AADL does not provide benefits for convenience and/or lifestyle.

Children's "wet feel" diapers not covered by AADL

AADL does not assist products when a child is toilet training. AADL’s program is for clients with daily (24 hour) moderate to severe urinary and/or bowel incontinence who, are not expected to gain continence.

Diaper supply

As per your contractual obligation with AADL, you cannot provide products into future months nor can you bill AADL. Vendors are only permitted to supply a client with their 2-month maximum authorized amount for the current two month period.

If a client is insistent on obtaining more than two month’s supply, advise the client of the following:

  • The client can purchase the extra supplies on their own for that 2-month period (they will not be reimbursed by AADL).
  • The client can contact their AADL authorizer for a reassessment.

An assessor will determine if there is a clinical need for an increase in the product or if a change of product in needed.

Dispense only one type of diaper

You are only permitted to dispense only one type of diaper as per the AADL category number listed on the clients form.

Clients authorized for M200 and M243 but only wants M243

M243 is a booster line, designed to be worn inside a full brief, diaper or M240 for extra absorbency. If your client is only using the M243, please alert the client's authorizer and AADL's program manager immediately. Your client will need to be reassessed.

No substitution of incontinence products under the client's authorization code

You are only permitted to provide products that meet AADL’s generic description and absorbency standards. Get the list of incontinence supplies approved by AADL.

Authorization expiration

Product(s) authorizations that have expired or near expiration

The client will require a reassessment. Advise them to contact their old authorizer or call Health Link at 811 to find an authorizer in their area.

No product until clients are reassessed

The client will be responsible for any costs if they let their authorization expire. In circumstances where there is a wait list for an assessment/authorization, the client may contact the AADL program and discuss an extension of their current authorization.

Hearing aid

Eligibility of seniors for hearing aid funding through AADL

A senior is eligible at the beginning of the next month after turning 65. Proof of age is required to register/verify senior status. The client can complete either the Proof of Age Declaration for Alberta Health Care Insurance Plan or the Alberta Seniors Benefit Financial Assistance Application.

Correcting a mistake on the audiogram

Once you receive the message "Audiogram Added," you cannot fix it. However, you can add another audiogram and put a note, by clicking on the scroll and quill icon in the authorization process to let the benefit area know you made an error and the second audiogram is the correct one.

Click "SAVE" after keying in the audiogram

If you click "Next" the information is lost, so click "Save." Remember to record your authorization number. From the menu choose the Maintain Authorization tab. At Step 3, key in the audiogram data again and click "SAVE". After you get the message “audiogram added”, you can click “NEXT” to continue.

AISH clients are cost-share exempt

All AISH and Income Support clients should be cost-share exempt. However, if they have never received any previous benefits through AADL before, they will come up as cost share. Simply call an AADL client services clerk and they will verify that the client is on one of those programs and update the client.

Assessment date vs. test date

The test date is used on the audiogram (Step 3). At Step 4, the Assessment Date should be the Fitting Date (start of the trial).

Assessment date for hearing aid repairs and replacement earmolds

The assessment date is the date the client picked up the repaired aid or earmold and signed the Service Certificate.

Mobility and large equipment

Option on manufacturer’s spec sheets

You can include options on the manufacturer's specification sheet for the wheelchair. However, they may not be funded by AADL. If the client agrees to pay for the option, AADL may include it on the order.

See the wheelchair and wheelchair part specifications and forms

Prosthetics and orthotics

Authorization for bilateral devices

You can create an authorization for a client who requires bilateral devices. The simple way of remembering how to record bilateral clients is 2-1-2

  • 2 lines on the "history" screen (1 for LL and 1 for LR)
  • 1 line on the authorization (Qty = 2 BL)
  • 2 lines on the claim (1 for LL and 1 for LR)

An example for bilateral clients is as follows:

  • Step 3 Update History Screen Requires two lines:
  • One line for LLAFO and
  • One line for LRAFO
  • Under the Benefit Information Screen enter:
  • One Cat # – qty 2 – indicate – BLAFO in serial number field.
  • The claim requires two lines:
  • LRAFO in serial number field
  • LLAFO in serial number field

Authorize a catalogue number for one side for bilateral clients

As long as the client history has the two lines pertaining to the bilateral device, you can enter in your catalogue number on Step 5 as a quantity of "1" and then put in the serial number for the affected side (i.e. LLAFO).

Put the correct devices in the serial number field of the claim

Refer to the Orthotic Grouping Table for the catalogue numbers for each device.

Error message "CAT # NOT VALID FOR ORTHOTIC DEVICE"

If you get this error message when creating an authorization, look up the catalogue number in the Orthotic Grouping Table to ensure it is under the correct device.