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Doctor and patient discussing treatment

Angel On My Shoulder provides consultation services to several memory care facilities in the Southern California area. The following letter was written to one of these:

To: XXXXXXXX

From: Carol Freeborn RN BSN CCM

The following is information regarding durable medical equipment for clients with Medicare as their primary insurance, effective 7-31-2013.

Medicare is phasing in a new Competitive Bidding Program in some areas of the country. This program changes the amount Medicare pays suppliers for certain durable medical equipment (DME), prosthetics, orthotics, and supplies, and changes who can supply these items.

The Competitive Bidding Program replaces the outdated prices Medicare has been paying with lower, more accurate prices. Under this program, suppliers submit bids to provide certain medical equipment and supplies at a lower price than what Medicare now pays for these items. Medicare uses these bids to set the amount it pays for those equipment and supplies under the Competitive Bidding Program. Qualified, accredited suppliers with winning bids are chosen as Medicare contract suppliers.

Medicare may only help pay for these equipment and supplies if they're provided by contract suppliers. Contract suppliers can't charge you more than the 20% coinsurance and any unmet yearly deductible for any equipment or supplies included in the Competitive Bidding Program.

What this means is if you do not use the company assigned to your zip code,  Medicare will not pay for home medical equipment such as Oxygen, wheelchairs, scooters. 

— Excerpt from medicare.gov

You can find the name of the company which services your area, and additional information at: http://www.medicare.gov/what-medicare-covers/part-b/competitive-bidding-program-areas.html.

Most zip codes in South Orange county are serviced by Lincare, Inc. out of Orange, CA. Linecare, Inc 7154-637-7570, Fax 888-696-7100.

Your physician will need to send a prescription and his/her notes stating why you need the equipment. Such as,

My patient needs a standard wheelchair with elevating leg rest (need to be specific as to type) because of reduced mobility due severe scoliosis and dependent edema. 

Both the Physician’s NPI number, Physician’s note, and prescription needs to be faxed to the provider.

If you have any questions or need help navigating Medicare further, please feel free to call us at (888) 391‑4043 or use our contact form.

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