How to find in-network DME provider

[southerndoc]

I contacted BlueCross/BlueShield of TN to see if there are any online DME providers that sell CPAP equipment. My ResMed AirSense 10 APAP is about 6-7 years old and is definitely time to replace. Initially I was going to get an AirSense 11 when they're released, but since I've already met my deductible it would make me ecstatic to get one provided by BCBS.

BCBS sent a list of DME providers near me, but none are online. When I contacted the first 5, none of them sell CPAP equipment. The list is 300+ providers long.

Curious if there is a better way to narrow it down or if there are any online retailers that participate in the Anthem/BCBS network as in-network providers.

[Julie]

Cpap.com sponsors this forum, has a great variety of everything, pix, graphs, etc. and are great to deal with (they're in TX) but you have to ask your insce. co. re network DME's online.

[Pugsy]

First you have to find an online retailer that wants to file insurance for you (and will wait for insurance to pay) and then you call them up and see if they are in network for your particular insurance company.

[Pugsy]

Cpap.com sponsors this forum, has a great variety of everything, pix, graphs, etc. and are great to deal with (they're in TX) but you have to ask your insce. co. re network DME's online.

In the US......

CPAP.com doesn't file insurance in lieu of payment for anyone. They aren't in network for any insurance company.
Now they will supply the universal insurance form for the person to file their own insurance but it's up to the insurance company if they want to pay for an out of network purchase or not.

Most people wanting to file insurance are wanting to have the insurance company pay their portion first and then bill for co-pay (if there is any) and most online retailers want people to pay up front so they don't have to wait for their money.

Filing insurance for people costs money....both in personnel and waiting to get paid. Most online retailers don't want to do that.

[southerndoc]

I would order for them, but if they're out-of-network then that's a totally separate deductible. Gotta love insurance companies.

[Pugsy]

To complicate things even more....with BlueCross/BlueShield each state is different and then within each state the plans can differ.
Nightmare.

I don't know of many online retailers that are willing to file insurance in the first place then the list is even further reduce by who they have in network contracts with.

There are some forum members to get in done though and I imagine they will stop by and tell you who they work with.
I have never done it myself...no one is in network with my insurance...

[southerndoc]

Have a feeling I'm gonna end up paying for it myself. The AS10's are definitely appealing with their steep discounts and the fact that Oscar may not work with the AS11's for a while after their released.

[Pugsy]

Check with
AeroFlow HealthCare
I know of them only because the file insurance and will supply the Bleep...phone number at the Bleep page
https://bleepsleep.com/our-partners/
I haven't checked yet to see if they are in network for me but I doubt it...but I have heard others say they used them and things worked out well.

NationWide (also on the Bleep page) will also file insurance.

Now whether or not they will work with your insurance...I have no idea but if you don't ask the answer is always "no".

Otherwise Verus is the only other one that comes to my mind that will file insurance for people and wait for payment.

[SleepGeek]

I found them on here ..--
Verus is contracted by many non-Medicare health plans nationwide. To find out if we are in your network, call us at 1-800-487-5566

https://verushealthcare.com/contact/

[Janknitz]

I found them on here ..--
Verus is contracted by many non-Medicare health plans nationwide. To find out if we are in your network, call us at 1-800-487-5566

https://verushealthcare.com/contact/

If they SAY they are contracted with your plan, be sure to VERIFY it with your plan.

[chunkyfrog]

Find the Medicare providers directory; narrow it down to durable medical/cpap, etc.
Compare that list with the one provided by your insurance.
The Medicare list will also let you change the search radius.
Online may not be possible with your insurance.

[SleepGeek]

If they SAY they are contracted with your plan, be sure to VERIFY it with your plan.

Good idea.

I contacted BlueCross/BlueShield of TN to see if there are any online DME providers that sell CPAP equipment.

Tho I've not known any company that will mail you things w/o first confirming payment from your insurance.

[Janknitz]

southerndoc wrote: ↑Wed Jun 02, 2021 12:02 pm
I contacted BlueCross/BlueShield of TN to see if there are any online DME providers that sell CPAP equipment.
Tho I've not known any company that will mail you things w/o first confirming payment from your insurance

If you send them the RX and they have your credit card "for the co-pay" they certainly will.