DME with BlueCross BlueShield?

dpmurphy · Post by **dpmurphy** » Mon Jan 21, 2013 8:39 pm

We have anthem BCBS here in NJ. I was using Medbridge to get my cpap supplies but as of 2013 they are no longer in network. Can anyone else recommend a good DME that they are pleased with and take Anthem BCBS NJ?

chunkyfrog · Post by **chunkyfrog** » Mon Jan 21, 2013 8:49 pm

Until someone in the area responds, you can check the provider list on your insurance company's web page.
You can call candidates, starting with the closest (for instance) and ask pertinent questions.
--like do they carry what you need, can they handle service on your machine, etc.

Sleepy Pilot · Post by **Sleepy Pilot** » Mon Jan 21, 2013 9:04 pm

Is CPAP.com a DME? Are they in BCBS network? Is BCBS of Louisiana different than yours in NJ? How do I buy stuff from CPAP.com and use my insurance?

archangle · Post by **archangle** » Mon Jan 21, 2013 9:23 pm

Sleepy Pilot wrote:Is CPAP.com a DME? Are they in BCBS network? Is BCBS of Louisiana different than yours in NJ? How do I buy stuff from CPAP.com and use my insurance?

Most insurance won't let you use an online DME and get full reimbursement. Or any reimbursement in most cases. A few people have been able to get some reimbursement for online purchases, but it seems to be rare.

They want the "quality" of a local brick and mortar DME. (Evil laugh about the "quality" part.)

I believe CPAP.com will give you an appropriately coded receipt, but won't process a claim. (Check with them for sure.)

You'll have to check your own insurance to be sure.

dpmurphy · Post by **dpmurphy** » Mon Jan 21, 2013 10:36 pm

The problem is that I have a EPN so I have to find a DME that is In Network. I don't have the option of paying out of pocket and then getting reimbursed. The only DME listed on the BCBS website was USHealthcare. Has anyone used them before?

dpmurphy · Post by **dpmurphy** » Mon Jan 21, 2013 10:38 pm

I remember reading (a while back) that cpap.com doesn't process any insurance claims. You pay up front and get reimbursed, which isn't an option for me.

Denial Dave · Post by **Denial Dave** » Tue Jan 22, 2013 5:17 am

check your insurance card.... it typically has a 1-800 number for you to call with any questions..

they can tell you who is in your network & approved

bjcyorkiemom · Post by **bjcyorkiemom** » Tue Jan 22, 2013 1:09 pm

A lot of times, the insurance company will have a website and on the website it will show "preferred providers" (for the insurance company).

Posey · Post by **Posey** » Tue Jan 22, 2013 1:29 pm

I would consider how the DME will charge also what will be your part and let that guide you. (Good luck getting prices out of either BCBS or a DME.) Some people say the lack of service and headaches from dealing w/ a DME are not worth it and just go with cpap.com. After getting my Resmed VPAP though Lincare, I now get the etc. online.

dpmurphy · Post by **dpmurphy** » Tue Jan 22, 2013 3:05 pm

I got connected with Nationwide Medical today. They are in network, and so far seem to be pretty helpful. We will see...

I've had problems in the past when the DME doesnt sell the mask cushions and onky wants to sell the full mask (so they get paid more). Problem is my insurance will only cover a mask every 90 days, while I can get a new cushion every 30. I've found that replacing even with cleaning the cushion every month gives me the best seal and in turn the best sleep.

jencat824 · Post by **jencat824** » Tue Jan 22, 2013 3:25 pm

dpmurphy wrote:I got connected with Nationwide Medical today. They are in network, and so far seem to be pretty helpful. We will see...

I've had problems in the past when the DME doesnt sell the mask cushions and onky wants to sell the full mask (so they get paid more). Problem is my insurance will only cover a mask every 90 days, while I can get a new cushion every 30. I've found that replacing even with cleaning the cushion every month gives me the best seal and in turn the best sleep.

I use Nationwide & generally have OK results with them. Only problem I had was they recommended my Icon & I got it from them (before I found this forum & learned about getting a better data capable machine). Other than that they are generally helpful. In the past they sent supplies well before I needed them. Now under new regulations I will have to request supplies, but when I request something reasonable they send it. They are very helpful if you have questions on an order or a problem. I hope you have as good of an experience with them as I do. I think I remember someone on the forum had a bad experience, but can't remember what it was.

Good luck & let us know if you encounter any problems.
Jen

dpmurphy · Post by **dpmurphy** » Tue Jan 22, 2013 10:29 pm

Thanks Jen. I will post the outcome in another day or so.

DME with BlueCross BlueShield?

DME with BlueCross BlueShield?

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Additional Comments: sized (not adjustable) Ruby style chin strap, Climateline Max tubing, NeilMed saline nasal rinse, RoEzIt nasal mositurizer