Advancing the health and well being of individuals needing Medical Equipment and Supplies should be the goal of your service provider. Another challenge is locating a Durable Medical Equipment and Medical Supplies provider who offers reasonable prices and is a reliable and informed source. Also, governing policies for determining payment towards equipment and supplies under Medicaid, Medicare and Private Insurance Institutions must be clearly understood to avoid unnecessary expenses by the patient.

Typically, service and supplies for which medical necessity is not clearly established are not covered. Included are items and services purchased from providers who are terminated or barred by the Insuring Organization. Routine medical supplies which are carried by Home Health Agency staff as they travel from home to home and which are available for use with any of their homebound patients are not separately reimbursable. Such supplies are considered included in the rate paid to the Home Health Agency. Medical items or supplies which are ordered by the physician for the Home Health Agency for the continuous care and exclusive use of a single patient are typically covered.

Under its prospective payment system, Medicare considers certain medical items or supplies to be the responsibility of the Home Health Agency, even if they are for the exclusive use of a single patient. Such items are not to be separately billed.

Special consideration for the following matters exist in the regulations governing coverage:

TIME LIMITS

REQUESTS FOR REPAIR

REQUESTS FOR REPLACEMENT

EQUIPMENT RENTAL LIMITATIONS

LONG TERM CARE RESIDENTS SERVICE LIMITATIONS

HOSPITAL INPATIENT AND OUTPATIENT SERVICE LIMITATIONS

Oxygen Supplies and Equipment

Oxygen for Long Term Care Residents

Apnea Monitors

Purchase and Replacement

Rental

Repairs

Customization

Batteries

ENTERAL THERAPY

INTRAVENOUS THERAPY

OTHER COMMONLY REQUESTED ITEMS

TENS Unit

Home Uterine Monitoring

Specialty Mattresses

Osteogenesis Bone Growth Stimulator

NOT ELSEWHERE CLASSIFIED (NEC) OR MISCELLANEOUS ITEMS