Call your insurance company and ask which suppliers (DME) are in their network.
Exactly. My new insurance provider has 3 levels of coverage. Affiliated (I work for a hospital), in network (non-affiliated), and out of network. So, I called the insurance company and they report that my Sleep Doc is affiliated (I can look that up on the hospital website) and they weren't sure about the DME because he's not a Doc. So, they had to call him to find out who his distributor is for the hardware. They are listed as being "in network" which is still 100% covered without copay/coinsurance/deductible.
However, they cannot complete a prior authorization with the patient; they have to confer with the DME provider. It's the DME's job to secure their prior authorization (agreement) that the item is covered. So, even if the DME is in the network, the DME will need to secure approval. Generally (and I have to do this at work at times for my own patients), it takes 1-3 days, sometimes as little as 20 minutes from the initiation of the phone call, but voicemails and whatnot..
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