Medicare Claims
PHC is a licensed Medicare provider.

Of the products covered by Medicare, about one-half are eligible for reimbursement when purchased over the Internet. The half not eligible for billing are rental items through Medicare and should be acquired from a local provider that can maintain the equipment for you. Unfortunately, these (Medicare) Capped Rental items include manual wheelchairs, hospital beds, sleep/support surfaces, respiratory equipment, patient lifts and slings. Read below to see which products are eligible for Medicare reimbursement and what you must do in order for us to file your Medicare claim.

• On Non-Assignments Medicare reimburses the beneficiary directly.
• You must pay for non-assignment products up-front.

• Medicare -  YES
• Medicaid -   NO
• HMO's  -      NO
• Insurance - NO

• Walkers & Rollators (non-assignment)
• Lift Chairs (non-assignment)
• Power Wheelchairs (non-assignment) see: Medicare Power Mobility Information
• Power Scooters (non-assignment) see: Medicare Power Mobility Information

• Manual wheelchairs and hospital beds are "capped rentals" with Medicare. We do not Rent. This means that you should contact a local dealer/provider that rents equipment.  Unfortunately, you don't have much choice of which equipment you will receive. 

• Bath products are not covered by Medicare.  However, a bedside commode may be covered if the patient cannot physically/independently get themselves to the bathroom.

• We file Medicare claims for Internet sales on a non-assignment basis.  Non-Assignment means that you pay for the product up-front.

• We initiate the necessary paperwork and submit it to Medicare on your behalf.  When filing on non-assignment, Medicare reimburses the beneficiary directly.  You pay the full amount up-front.  If you have secondary insurance you may contact them for filing procedures.  In some cases Medicare automatically submits the claim to the secondary carrier.

• Doctor's prescription for the product.  We cannot do anything until we have the Rx.  The Rx must be dated before the product is delivered. 
• Once we have your Rx we will mail you a Medicare Claims Packet.  Then some of the forms included in the packet must be returned to us.

• No.  We provide you with the CMN. You simply give it to your physician to sign and return it to us. Our billing department files an electronic claim with Medicare for you.
• Remember, we mail you the CMN ready for your physician's signature.  You do not need to download the CMN from our website except to review it.
• Want to see the CMN for your product?  Sure.     Click here to download a CMN forms

• No, Medicare does not give prior approval except for high-end powered wheelchairs.  If someone has told you otherwise, make the call to Medicare yourself, 1-800-MEDICARE

• Depends on which product.  Some take a relatively short time while others take longer.
• Walkers, Rollators, and Lift Chairs are straightforward products that reimburse in a relatively short time (4-9 weeks).
• Some Power products such as Electric Wheelchairs and Scooters generally take longer.

• Patient's full legal name, address, phone number.
• Patient's date of birth.
• Patient's Medicare number (including the alpha character after the number).
• Patients height & weight.

• Doctor's Prescription for the product.  The prescription should include the patient's diagnosis.
• Physician's name.
• Physician's address.
• Physician's telephone number.
• Physician's fax number.
• if you are seeking Medicare reimbursement for a power scooter or power wheelchair see the physician requirements: Medicare Power Mobility Information

• Doctor does not complete the required information on the CMN.
• Missing or inaccurate patient information.

• FAX or mail the information to us:  214-265-7817

•  Understanding Medicare

• Medicare Frequently Asked Questions  (faq)

• Medicare reimbursement amounts