I rented a portable oxygen concentrator for use while travelling and the medical supply company required payment by credit card bc they said that Medicare would not pay them for this item. I have a supplemental insurance that will pay for things not paid for by Medicare. OK, I know that no insurance company guarantees payment but I want to make a serious effort to be reimbursed for this item. Any suggestions you might have will be appreciated., I have worked in medical billing, but my experience is with billing for a medical doctor’s office, not for medical supplies. Thanks.
I do not believe that you will be reimbursed, and although I don’t have all of the information here’s why I say that.
An oxygen concentrator IS a Medicare approved item. This means that Medicare WILL PAY for the rental of this item. However, you must get this item through a Medicare approved supplier; Medicare will not pay for services, equipment or supplies not received through an approved provider. If Medicare will not pay in most cases neither will the Supplement. The business must have a contract with Medicare. Businesses that do have a contract must provide you, in writing, an ABN form which explains what items and services that Medicare will not pay for and why. From what you stated that the company rep said, and since you didn’t mention this form, I do not believe the supply company is a Medicare approved business and therefore neither Medicare nor the Supplement will pay.
Secondly, in most cases a supplement does not pay for things not paid for by Medicare. Instead, a Supplement pays your share of the cost of Medicare approved procedures, equipment, and supplies. For example, if the concentrator cost $100 Medicare would pay $80 and the Supplement would pay your share of $20. You do not need to get approval from Medicare nor the Supplement. If you have a Medicare Advantage plan, which works completely different from a Medicare Supplement, you may need to get approval prior to the rental but again the supplier must be contracted with Medicare before you’ll get reimbursed. Also, even with an Advantage plan durable medical equipment is not covered if it is not a Medicare approved item.