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PatientDirect bills the patient's insurance company for the rental of the pump and associated disposable supplies. Your office bills for the medication, hook-up, supervision, post access, disconnection of the pump, and associated charges.
PatientDirect third party medical billing service is a licensed Medicare Provider
As a licensed Medicare Provider of Durable Medical Equipment (DME), we must bill in accordance with Medicare/CMS guidelines as follows:
- Bill the patient’s primary insurance carrier for monthly pump rental and supplies.
- Bill the patient’s secondary insurance carrier for any amounts not covered by the primary insurance carrier.
- Bill the patient directly for any co-pay and/or deductible that is dictated by their insurance carrier(s).
Managed care - insurance considerations...
We are an in-network provider with many managed care providers, but we work on a patient-by-patient basis to verify / negotiate our pump usage and supply reimbursement.
Many patients’ insurance plans dictate that they must have a Primary Care Physician (PCP) Referral Number (a.k.a. Authorization Number) when starting them on an ambulatory infusion pump provided by PatientDirect medical billing services. If your facility needs a PCP Referral / Authorization Number to bill for your services, so will we.
When your office calls the patient's insurance company of the referring physician to get authorization for performing ambulatory infusion of chemotherapy medications via the pump provided by PatientDirect, your office will need to inform the authorizing party that you will be using an infusion pump provided by PatientDirect.
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Take a look the stationary & ambulatory pumps we have available
for rental or purchase from PatientDirect through our online catalog
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