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Last Reviewed: November 19, 2020. ). xref Personal convenience or comfort items including, but not limited to, such items as TV's, telephones, first aid kits, exercise equipment, air conditioners, humidifiers, saunas, hot tubs. Does the Patient’s condition require frequent changes in body ... An Independent Licensee of the Blue Cross and Blue Shield Association. Durable Medical Equipment (DME) Actigraphy; Adjustable Cranial Orthoses for Positional Plagiocephaly and Craniosynostoses; Cardioverter Defibrillators: ... ©2021, Blue Cross Blue Shield of Alabama is an independent licensee of the Blue Cross Blue Shield Association. Some plans only cover certain brands or equipment from specific manufacturers. Anthem Blue Cross and Blue Shield Durable Medical Equipment Policy and Ancillary Fee Schedule Updated . Durable Medical Equipment (Purchase and Rental) Reimbursement • The maximum allowable for durable medical equipment classified as Capped Rental, Inexpensive/Routinely Purchased, TENS, and enteral nutrition infusion pumps (i.e., purchase and rentals) will be the lesser of charges or the contracted network percentage of the RR: Rental . “Deluxe” electrical or mechanical features, which enhance basic equipment usually serve a convenience Durable Medical Equipment (DME) DURABLE-1 Durable Medical Equipment (DME) Benefit Coverage . Blue Cross Blue Shield of Michigan and Blue Care Network members under age 65. Devices and equipment used for environmental accommodation such as, but not limited to, chair lifts, stair lifts, home elevators, standing frames, and ramps are specifically excluded under most health benefit plans. Blue Cross and Blue Shield of Montana will process the claim. Some Blue Cross Blue Shield insurance plans not only cover a double electric breast pump, but they may also cover replacement parts for your breast pump as well. The durable medical equipment not covered by your insurer under your benefit plan include: Cleaning supplies such as Mask wipes and cleaning machines, like the SoClean 2 or Lumin CPAP Cleaner. Depends on the plan and the state you're in. Delta Dental provides services for dental benefits, including access to the Minnesota Select℠ Dental Network. BCBSNC will provide coverage for Repairs, Maintenance and Replacement of eligible DME when it is necessary to make the equipment usable. 0 You can always give us a call. ... First Care, Inc., and The Dental Network, Inc. are independent licensees of the Blue Cross and Blue Shield Association. 9900 . The best way to get information about your plan is to log in to your account. The good news is, your health insurance typically covers durable medical equipment. However, each plan covers durable medical equipment a little differently. Box 362025 Birmingham, Alabama 35236-2025 Fax: (205) 989-3899 12. First, you’ll need a prescription. Does CareFirst cover services by Certified Nurse Midwives and Direct Entry Midwives? DURABLE MEDICAL EQUIPMENT CERTIFICATION P.O. An ancillary provider is a Durable/Home Medical Equipment and Supplier provider. This link will take you to a new site not affiliated with BCBSTX. NU: New durable medical equipment . Anthem Blue Cross and Blue Shield Professional Reimbursement Policy IN, KY, MO, OH, WI 0022 Durable Medical Equipment Page 1 of 8 Anthem Blue Cross and Blue Shield is the trade name of Anthem Insurance Companies, Inc. Does CareFirst Require Prior Authorization for Durable Medical Equipment? 49 0 obj <>stream Unless the insurance company decides these improvements are medically necessary in your circumstances, they will not be covered as DME or through another part of your health insurance. Unless the insurance company decides these improvements are medically necessary in your circumstances, they will not be covered as DME or through another part of your health insurance. How do I purchase durable medical equipment? ... durable medical equipment: Medical supplies that cost $1,000 or more require prior authorization. In general, Blue Cross Blue Shield considers convenience items and duplicate equipment not medically necessary and thus does not cover them. Or maybe you've had a baby and need breastfeeding supplies like a breast pump. However, there are unique circumstances when claims filing directions will differ based on the type of provider and service. startxref 0000001794 00000 n 0000001037 00000 n Durable Medical Equipment (DME) This document is provided as a supplement to the Blue Cross and Blue Shield of Illinois (BCBSIL) Contract Agreement with all Durable Medical Equipment (DME) providers to familiarize you with BCBSIL policies concerning DME, particularly life sustaining and non-life sustaining equipment as specified in your contract. Circumstances Affecting Rental Reimbursement The reimbursement limit for rented DME is 10 months. The appliances themselves are categorized by Medicare as durable medical equipment (DME) and are not dental devices. ®† Blue Shield is a registered trade-mark of the Blue Cross Blue Shield Association. Some plans require you to pay a deductible before they begin to pay for your durable medical equipment. RR - Rental (use when DME is to be rented) UE - Used durable medical equipment . Durable Medical Equipment (rent to purchase) policy and the associated fee schedule found at the links below. *Delta Dental of Minnesota is independent from Blue Cross and Blue Shield of Minnesota and Blue Plus. Blue Cross Blue Shield of Michigan and Blue Care Network members under age 65. You might also want to check your plan benefits. x�b```f``z���������xX����� #Î�C���3V,H�:�S�4�]���2ߒ�OVn��r/���u�C�t���O���J�,�i6� �a������x�܊0͚�*BvPD���$H�C�@������[Jq���Zv����]�����nֆ2v���Zցlb[ �g`��d90 ��> endobj 34 0 obj <> endobj 35 0 obj <>/ColorSpace<>/Font<>/ProcSet[/PDF/Text/ImageB]/ExtGState<>>> endobj 36 0 obj <> endobj 37 0 obj <> endobj 38 0 obj <> endobj 39 0 obj [/ICCBased 48 0 R] endobj 40 0 obj <> endobj 41 0 obj <> endobj 42 0 obj <> endobj 43 0 obj <> endobj 44 0 obj <>stream 0000004282 00000 n Simply use our Find a Doctor tool on bcbsm.com or our mobile app, and search for durable medical equipment. To be considered durable medical equipment an item must be: • Made to withstand repeated use. Durable medical equipment includes, but is not limited to, the following: hospital beds, crutches, canes, wheelchairs, walkers, peripheral circulatory aids, cervical collars, traction equipment, physiotherapy equipment, oxygen equipment, and ostomy supplies. The local Blue Plan as defined for Examples of life -sustaining equipment include oxy gen equipment such as concentrators, Not Registered? In general, Blue Cross Blue Shield considers convenience items and duplicate equipment not medically necessary and thus does not cover them. 32 18 Blue Cross & Blue Shield of Rhode Island Subscriber Agreement, HMC2C 2013 Centers for Medicare and Medicaid Claims Processing Manual. Blue Cross Community Centennial covers your physical health care needs. Blue Cross and Blue Shield of Texas (BCBSTX) gives health care benefits and access to care to help your child stay well. With NJ DIRECT, you have access to one of the largest doctor and hospital networks in New Jersey and 1.3 million providers nationwide through the BlueCard® PPO Network. Intermittent pulse oximeter monitoring (less than 24 hours) for home use may be considered medically necessary durable medical equipment ... Blue Cross Blue Shield of North Dakota is an independent licensee of the Blue Cross Blue Shield Association, serving residents and business in North Dakota. Blue Cross will consider medical equipment to be purchased after ten months rental. Maybe you need a wheelchair to get around, an oxygen tank to help you breathe or supplies to help you manage diabetes. You can do that using our website or through our mobile app. Intermittent pulse oximeter monitoring (less than 24 hours) for home use may be considered medically necessary durable medical equipment ... Blue Cross Blue Shield of North Dakota is an independent licensee of the Blue Cross Blue Shield Association, serving residents and business in … DME is typically used to help you do things that you might be unable to do because of medical circumstances. I had a Blue Shield small business gold plan with my former employer and Durable Medical (pump and CGMS) supplies were only covered at 50%. Blue Cross and Blue Shield of Vermont is an Independent Licensee of the Blue Cross and Blue Shield Association. h��WQs�6~ׯ�#��h�")iou�۲K֦Qo�4�v���T����� ��u��v�ڗ�wE� ��:���v�&�t#a�EFs�B�3� ��yJ�"��E�H }I�}DO�7Tʅ�� B����J�d]G�2��BE��e�Jf��r��k& (���!b�F�%)�"crȌ�ւ�d� ��4�2�+�5)0&�~P��22�Z졯?%�ɉԤ).�ȼe�m[��tp�f��Z���m}�r�ޱ����^�\��݇.h$V�r��Rr�ZrEh�(T-��o�{e�������qπ��伀r%䯡p�B:}��g㛋Kxݮwq��f�̵pU5�j���3��De�&���_>�?C�������˨!dOr�:�9��j��A�\�ԗ�Ǭ��!��* �3b�H{d"u�#Lܼ&!M*E� oYSo�u'���o��#32��ȸ�GS0@�O����O�13 �Za!�\�\d岞;��v���b�0��R�4@"�DJ��=�)�9"��ܞ���޿a���W=Ę�)[�X�k�m���zYOP��.

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