Online DME for Anthem?

Does anybody know of a good online DME that takes Anthem Insurance?

I need to move away from my local Lincare provider. They are a pain & generally dishonest.

I've been using Sleep Central https://www.rotech.com/supplies, which now goes by the name of its parent company, Rotech. I've gotten my machines through their local DME, but supplies come via their online service. I've had some problems with claims and wrong supplies sent, but they never gave me trouble. It is now all streamlined - I place the order online and they ship it and bill Anthem.
McSleepy

That's great.
I need to order a mask. Do they list their prices online or do I need to call them?
I have a prescription.

You might also check with Verus. I think they work with a good number of insurance plans.
Best source is to get a list from your insurance as to who they have contracts with.

https://verushealthcare.com/commercial/

I'll second the Rotech recommendation for Anthem. My local DME is a Rotech franchise as well. The thing is though...my deductible is way, way, higher than I could ever spend on CPAP (by several thousand bucks), so it don't use them. The negotiated prices are ok, but no real reason to use them since the cost is the same or less at any online place, and I'm paying out of pocket either way. I just go with whatever place I feel like using at the moment.

These sites seem to focus on supplies.
I assume they do not need a prescription then?

prodigyplace wrote:These sites seem to focus on supplies.
I assume they do not need a prescription then?

Supplies generally don't need a prescription. Full masks with headgear attached typically do need a prescription, however. For some vendors they do offer masks with headgear as an add-on (just has to be attached by you) without a prescription.

If you are going to want to file with your insurance you are most likely going to have to furnish a RX at these places especially for stuff related to masks. While officially only the complete mask package requires a RX there are some ropes that the DME has to jump over to file insurance and one of those ropes would be a RX and some diagnosis information.
A lot of the cpap supplies can be bought without RX but to get insurance payment...more information is going to be needed and one of the things they will want is a RX.

Pugsy wrote:If you are going to want to file with your insurance you are most likely going to have to furnish a RX at these places especially for stuff related to masks. While officially only the complete mask package requires a RX there are some ropes that the DME has to jump over to file insurance and one of those ropes would be a RX and some diagnosis information.
A lot of the cpap supplies can be bought without RX but to get insurance payment...more information is going to be needed and one of the things they will want is a RX.

Thank you. I have a prescription in my possession. I want to order a mask, but will obviously need supplies later.
I need to consider my options. I could order the mask from cpap.com but I do not really want to continuously file insurance for supplies if that can be avoided.

Sorry for the delay in responding. One of the snags I experienced with Rotech was them getting a prescription from my doctor who had left the clinic, so it was quite the saga. But this was for a full mask. Since then, I had never had to do anything about prescriptions or insurance. Maybe they got a hold of my new doctor, maybe the got creative - last time I asked for a mask, they sent me bits and pieces that didn't amount to a whole mask. As for cost, they don't show prices on their website - you can see for yourself by following the link I posted, it's not like a storefront. But my insurance covers DME at 100% (I have secondary), so it's my preferred way to get supplies. I should note that I don't come close to abusing that - I get masks every few years and I'm still on my original humidifier tanks, hoses, etc. I get filters, nasal pillows, and the occasional mask parts.
McSleepy

Thanks all. Here is my plan.

I have a written prescription in hand. I will scan it to pdf.
I will upload the prescription to cpap.com and order the mask, submitting the insurance claim myself. I assume cpap.com will give me the necessary codes.

I can then use the prescription for supplies from Rotech.

I will order the mask from cpap.com because of the better return policy and to support this forum.

I think this plan is probably the best direction, Any (on-topic ) comments?

cpap.com will supply you with a universal insurance form with appropriate codes but make sure that your insurance will accept it and pay/allow a charge from cpap.com. Some insurance will and some won't reimburse at all and some will but at a reduced rate.

Pugsy wrote:cpap.com will supply you with a universal insurance form with appropriate codes but make sure that your insurance will accept it and pay/allow a charge from cpap.com. Some insurance will and some won't reimburse at all and some will but at a reduced rate.

Thanks Pugsy.