ReSupply Ordering Process
INSURANCES REQUIRING PRIOR AUTHORIZATIONS & THE PROCESS:
Blue Cross Blue Shield- requires a compliance download via SD card or wireless modem (Airsense & Dreamstation models have data provided through modem). Compliance must show a recent three month period of usage with 30 consecutive days higher than 70% for insurance approval.
*Please see the “Compliance/Download” section for options to get your SD card to us.*
Tufts, Harvard Pilgrim, Carecentrix, Always Health Care, My Care Family, Northwood & Senior Whole Health- does not require any compliance download or proof of usage. All requests are submitted via online portal by our team. Determinations are made within 48 hours of submission. Some payors require the physicians RX on file to be faxed as a supporting document.
UPDATED DOCUMENTS:
In addition to Prior Authorizations, your insurance at times may require we obtain an updated “renewal” supply RX. Please always provide our representatives with the physician you are actively seeing (even a primary care). Having your file accurately reflect your current physician will help in expediting any documentation requests we may require.
Currently Medicare is the only insurance requiring an updated document from your physician to be on file every year. If we do not have a document showing continuing need on file, we will request an updated RX to fulfill these guidelines.
New documents may also be required when changing to a new insurance payor. When changing to a new insurance, please contact us to provide the updated information and discuss what may be needed.
How to Order Supplies
In addition to contacting us when you are ready, we provide an automatic resupply system that will reach out to you to see if you are in need of any items and need an order placed. This service is called All Call and it has two options for contact type. Here is the information on enrollment and options.
All Call
Once you have achieved your initial compliance under insurance guidelines, you will be automatically be enrolled in All Call. For all patients enrolled in All Call, please add 1-877-412-5778 as a contact in your phone. This will help avoid failed attempts by the All Call team in connecting with you. Please also use this phone number for placing orders or returning calls from the All Call team.
LIVE CALL FROM A REPRESENTATIVE
Once enrolled, you will immediately receive a call from a representative to discuss what you need and place the order. Going forward, they will reach out to you every ninety days when you are again eligible for items. After four failed connection attempts (messages left, no answer, hangups), All Call will stop reaching out and resume once we receive a call back from you to go forward. You may update any information (insurance/ address/ current physician) with the representative, as well as request a call back from our team if you have any questions or concerns.
How Will my Order be Arriving
SHIPPING
Our resupply orders are processed through a fulfillment center to ensure all items are available for you. Home Care Specialists absorb the cost of all shipping so all resupply will be delivered via USPS to you free of charge. Patients can expect to receive their order within 5-7 business days once the order is shipped. Any patients registered in our supply portal will receive an email notification when their order is on its way with tracking information included. Patients are able to receive tracking updates if they provide an email, when placing an order.
Any non-portal patients who would like to check the status of their order can do so by emailing into resupply@hcshme.com . (Please include your name and account number or other form of verification so we can access your account.)
IN OFFICE PICK-UP
Our main office, located in Haverhill, MA is also an option when it comes to receiving your replacement supply items. Our other locations in Concord, NH, Portland, ME, and Hermon, ME, are also available pickup locations, however, please call ahead to verify stock, before making the trip. Since we are not a fulfillment center, not all items are kept in stock and available for pick up in every location.
We urge all patients to contact our office PRIOR to coming in for resupply items.
This will allow us to make sure we have the items available, as well as to make sure there is no authorizations or documents required by your insurance prior to providing the items to you. Contacting us ahead of time to make pick up arrangements is time saving for you and for our staff.
There is a Problem with my Items
INCORRECT ITEMS OR ITEMS NOT NEEDED
In the event you receive an incorrect item, there are two ways for us to rectify the order. By placing a call to our office or emailing us, we can send out the correct item with a postage paid return label for the wrong item(s) to be returned to us. If you received an order in error and wish to return the entire package, just the return label will be mailed to you.
If you wish to come into our main office to exchange the items, please contact us first. By contacting us, we can make sure we have the correct item in stock and have your order ready for you when you arrive.
RETURN POLICY
All items that are wished to be returned/exchanged, must be done so in a timely manner. Since these items are being submitted to insurance, there is a thirty-day window to make the arrangements for the return/exchange with us.
Any item(s) that were opened in error will not be accepted back or refunded.
**Please make sure when you receive an order, you are opening the package immediately to verify that all items are correct and that they were requested by you**
FAQS
I received my new mask and I am having problems connecting it to my tubing?
All CPAP tubing is universal and compatible to all masks regardless of manufacturer. Most masks have plastic cylindrical adapter that fit snuggly into the rubber end of your tubing. IF you are having issues attaching the two, most likely it is the mask adapter. When separating the two, this adapter can sometimes come off the mask (making the mask loosely fit into a new tube) and making your tubing unable to have a new mask connected. If your tubing is correct and ready to be attached to a mask, you should be able to pinch the end shut, showing that there is no adapter stuck inside.
Why do I need an SD card in my new machine when it has wireless modem capabilities?
All machines have a data card inserted as a backup for compliance download. Although the modem wirelessly transmits your usage to us, if the modem ever proves faulty, the card can be provided to us to download your compliance information. If you lose or misplace your data card and it is needed for a download, your CPAP machine also records the information internally so we can insert a new SD card and retrieve the information that way.
When I order my replacement mask, it often does not come with the fabric headgear. Why does this happen and how do I use the new mask?
Insurance guidelines state that the mask (frame with cushion) can be replaced every ninety days. The guidelines on the replacement headgear are one per 180 days. In the interim, you will have to remove your current headgear and attach to the new mask set up. Some styles of mask are tricky when it comes to replacing the headgear. We direct patients in this situation to go online and search a video showing how to remove and replace the headgear to their specific mask.
I received my order and told I was “eligible” for these items, why have I received a bill for all or a portion of the cost?
Although you are “eligible” for items based off the insurance replacement schedule, it does not mean that you are covered 100%. We can do our best to tell you what your policy coverage is for DME, but it is the patient’s responsibility to contact their insurance carrier and find out the specifics on current deductible, copay and benefit details.
One of my supplies broke and I am not due for a replacement yet through my insurance
If any of your supplies need replacement prior to your insurance eligibility date, you can place an order and privately pay for the item. The payment will be taken over the phone by one of our team members and shipped, or if we have in stock, it can be picked up and paid for in our main office.
I will be traveling throughout the year. How do I go about staying on track with my resupply orders and shipments?
Every time you speak with one of our representatives to place and order, please clarify with them which address you would like that order to be shipped to. We can ship to any address within the United States at no charge and update your account accordingly for each placed order.
Why can I not replace certain CPAP parts any longer?
At some point the manufacturer will start deeming parts on older machines as “obsolete”. Although the machine could still be functioning properly, some items (or masks) will be discontinued. In this case, if it is the mask, you could contact our office when you are eligible for a replacement and schedule a refit too.
I do not want to be contacted at all and prefer all eligible items be shipped out when I am due automatically.
We CANNOT ship any resupply items to you without your approval EACH time. Due to changing insurance coverage and the possibility of unneeded supplies being sent, the patient must approve every order with our team. Automatically sending out items that will be billed to your insurance is fraudulent. If you do not wish to be contacted via phone or email, you can opt to contact us directly each time you would like replacements shipped out.
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