Insurance Reimbursement FAQs
Does TheCPAPPeople.com accept or bill private insurance?
TheCPAPPeople elected to deal directly with the customer simply because we want to offer several choices with very affordable prices. There are many of you out there who do not have insurance coverage or you are dealing with very high deductibles and co-pays. So, affordability and choices are good!
Does TheCPAPPeople.com accept or bill Medicare or Medicaid?
We do not bill either Medicare or Medicaid.
Can I get reimbursed by my insurance company?
Since we do not bill private insurance, Medicare or Medicaid it is not to say that you cannot get reimbursed for your CPAP expenses. TheCPAPPeople.com cannot guarantee reimbursement from your insurance provider. We do make available for your convenience a Universal Claim Form
(CMS 1500) or as it is called on our site the Health Insurance Claim Form, which is widely accepted by insurance providers. But, be sure and ask your provider if they accept this type of form. They may have their very own they prefer you to use. We want to assist you in getting all the benefit you can from your provider, so we want to keep you as informed as we possibly can!
While we want to assist you in getting a reimbursement, we also need to inform you that we cannot make any determinations about your insurance coverage or policy. Please verify with your insurance provider if reimbursement via a claim form is permissible. You will probably be able to get this information from member services or even from your human resources department where you are employed.
Do Medicare and Medicaid allow claim forms to be presented for reimbursement?
Currently, they do not.
Does TheCPAPPeople.com provide necessary insurance codes for reimbursement?
In order to help in this process, we recommend you attach a copy of your invoice to your claim form. Why, you may ask? Well, check it out! We supply the required codes for all reimburse-able items right there on your invoice! You will notice that there is a corresponding code per item. You may also notice there may be two codes listed under one item on your invoice. For example, if you order a CPAP mask, the mask itself has a code (HCPCS A7030), and the headgear has a code (HCPC A7035). So, we make sure you are covered!
What are these codes and why are they called HCPCS codes?
HCPCS Codes, Healthcare Common Procedure Coding System numbers, are the codes used by Medicare and monitored by CMS, the Centers for Medicare and Medicaid Services. HCPCS Codes are numbers assigned to every task and service a medical practitioner may provide to a Medicare patient including medical, surgical and diagnostic services. Everyone uses the same codes to mean the same thing, so they ensure uniformity. They still work even though we do not bill insurance or Medicare and Medicaid.
Comfort items like CPAP pillows, tubing guides and covers, aromatherapy, and power accessories are not covered.
CLICK TO SEE A COMPLETE LIST OF HCPCS CODES
What is typical replacement schedule for insurance billing?
- CPAP Mask - 1 every 90 days
- CPAP Mask Cushion - 1 every 30 days
- CPAP Nasal Pillows - 2 pairs every 30 days
- Tubing - 1 every 90 days
- Headgear - 1 every 180 days
- Non-disposable filters - 2 every 180 days
- Disposable filters - 2 every 30 days
- CPAP/APAP/BiPAP machines - Varies
How long do reimbursements take?
We hear from our customers and experience it ourselves. It may take up to 30 days, and sometimes longer depending on your provider. You may want to check with them to get an idea of turnaround time.
Are you a network provider?
No, TheCPAPPeople.com will always be considered an “out of network provider”. We do provide our Federal Tax ID # for insurance reimbursements. SEE COMPANY INFO BELOW
Do you provide a Diagnosis Code?
Typically the physician will provide that code for Obstructive Sleep Disorder (OSA) in the sleep study or sometimes on the physician order. But, you can find it here too! It is 327.23. Your insurance provider will require this information. We recommend you always call your physician’s office if ever you need clarification or if you are ever in doubt.
TheCPAPPeople.com company info:
Mr CPAPs, LLC
7439 Whitepine Road
Richmond, Virginia 23237
Federal Tax ID #: 46-1066755
Please, just give us a call if you have any questions or if you need some help!