How to Bill Your Health Insurance for Your Out-of-Pocket Expenses
Receiving the benefits of reimbursement from your insurance provider does not have to be difficult. Remember that the first time doing anything new is the most difficult! Below you will find general instructions for filing an insurance claim on your own behalf for home and portable oxygen concentrators, CPAP and BiPAP supplies. Please Note: Medicare does not allow patients to submit claims on their own behalf. These claims must be billed from a medical equipment company with a Medicare provider number.
Please Note: The information provided should be considered general instructions for reimbursement only. As the policies and procedures for each insurance company may vary American Medical Sales and Repair cannot determine nor guarantee that this information is accurate for your specific policy. Please verify the following information with your company prior to filing a claim.
- Contact the Member Services Department at your insurance company and request the necessary information required to submit a claim for reimbursement of medical expenses paid out-of-pocket.
- Ask your representative if this Health Insurance Claim Form that is approved by the National Uniform Claim Committee may be accepted for submitting claims. If it is acceptable, you can download it here.
- Complete the required form accepted by your insurance company. Whether your insurance company will accepts the common claim form that we have included or not, you may find it helpful as a guide. For your convenience we have highlighted the essential areas. On the form you will find our Tax I.D. number company name and address.
- Attach a copy of your receipt received from American Medical Sales and Repair. It is very important that you separate your purchases into specific categories. For instance: If you have purchased a CPAP mask that comes with headgear, the insurance company will process the cost of the mask and headgear separately. The cost of your mask will be 70% and the headgear will be the equivalent of 30% of the total cost. To simplify the process you will find the required billing codes below.
- Follow your insurance company’s submission directions whether that is by fax or U.S. Mail.
- Reimbursement time is approximately 30 days. Ask your insurance company for a precise turnaround time.
Billing CodesThe following HCPCS codes are universally used by insurance companies to process claims. Pay close attention that the appropriate codes on your claim form are used to ensure timely processing. Codes should correspond to each separate item on your invoice. Please Note: Items such as CPAP bed pillows, batteries, and DC adapters are not covered as they are considered luxury items. If you need assistance please call your American Medical Sales and Repair representative for help at 1-877-774-9271.
E0601 - CPAP machine purchase
A7034 - CPAP nasal mask
A7032 - CPAP nasal mask cushion
A7030 - CPAP Full Face mask
A7031 - CPAP Full Face mask cushion
A7044 - CPAP Full Oral Interface
A7046 - CPAP Humidifier Chamber
A7037 - CPAP tubing, long and short hoses
A7038 - CPAP disposable filter
A7039 - CPAP foam filter
A7035 - CPAP headgear
A7033 - CPAP nasal pillows
A7036 - CPAP chinstrap
E0561 - CPAP Passover Humidifier
E0562 - CPAP Heated Humidifier
E0470 - BiPAP purchase
E0471 - BiPAP-ST purchase
A4604 - Thermo Smart Tube
K0553 - Oral/Nasal (Hybrid) Mask
K0554 - Oral Cushion for Hybrid Mask
K0555 - Nasal Cushion for Hybrid Mask
E1399 - CPAP Miscellaneous (this code is to be used for any CPAP items covered by your insurance but not listed above.
Diagnosis CodesObstructive Sleep Apnea: (For CPAP Users): 327.23 Hypoxia: (For O2 Users): 799.02 (Contact your physician if you have any questions about your Diagnosis Code)
Your insurance company may require information about American Medical Sales and Repair to process your claim. Here is our address:
American Medical Sales and Repair
7042 S. Revere Parkway, Suite 450
Centennial, CO 80112
Tax ID Number: 27-1458664