Most of our products can be purchased or rented without a prescription, but, if you want your insurance carrier to pay for the item, you must first begin with your physician and obtain a prescription.
Insurance companies will not consider coverage for an item without an order from your physician. Medicare requires all patients to have a face-to-face encounter with their physician before they will cover an item. Asking your doctor to “call-in” a prescription is not acceptable for Medicare coverage.
The first reason may be that your item was denied by your insurance. The decision to cover items is determined by the insurance company and not your physician. Because of this, the items your physician thinks will be covered may actually not be paid by your insurance company.
The second reason you may have received a bill is that you have a co-payment. Very few insurance companies will cover your item at 100 percent. The most common coverage percentage we see is 80%, which means you are responsible for the remaining 20%. It is your responsibility to determine these coverage percentages before you transact business with us so you will know your co-payment amounts. We are not responsible for determining this information for you.
The third possible reason you may have received a bill is because you are required to pay a deductible. Most insurance companies require you to pay a deductible balance before they begin paying their coverage percentage. If this has happened here, you may have a remaining deductible to pay toward your transaction with us.
Oxygen is regulated by the FDA and requires a prescription before it can be dispensed. You will need to make an appointment with your physician so he can measure your oxygen saturation percentage.
Most insurance companies will cover oxygen if your saturation percentage is 88% or less, either at rest or during exertion. Arkansas Medicaid requires arterial blood gas tests to determine if you meet their criteria for coverage.
First we must verify that you have owned the equipment for more than five years. For insurance coverage, a new machine is typically not covered until your current unit has met it’s five-year “useful life”. If it is older than five years, current titration sleep studies are required to determine your settings.
You will need to make an appointment with your sleep doctor to discuss your current sleep symptoms and have new titration sleep studies performed. Once this is complete, we can get you a new machine with a new prescription and new studies.
We are not able to do in-store financed accounts. Payment in full is expected at the time of service. We accept Cash, Check, VISA, Discover, MasterCard and CareCredit. Only in rare circumstances would we consider accepting installments.
It is against health care law for us to offer to waive co-payments. You will be required to pay all co-payments and deductibles associated with your transaction with us. If you can prove a financial hardship, we may elect to waive these payments, but this is rare.