Care Airways Unassigned Form

Attention

Medicare Patient’s

We want to inform you that Medicare pays for your Home Oxygen Concentrator (E1390) and your Portable Oxygen Concentrator (E1392) as a monthly rental for a total of 36 months or whatever months are left if you are currently renting oxygen equipment with another supplier. This is a rental, and not a purchase from Medicare. 

The DME Company will provide you a working unit that they have available within the brands that are approved. These can be new or used equipment.

You as the patient have been informed that Care Airways Corp will NOT accept Assignment for Home Oxygen Concentrators (E1390), and Portable Oxygen Concentrators (E1392). 

You as the patient have elected to purchase a new Home Oxygen Concentrator and/or a new Portable Oxygen Concentrator from Care Airways and make a full payment in advance. You want Care Airways Corp to bill on your behalf to Medicare for the equipment you received whether is a Home Oxygen Concentrator (E1390), a Portable Oxygen Concentrator (E1392) or both depending on the items you received. You will be reimbursed as a monthly rental payment for the months you have left of the total of 36 months that Medicare stipulates.

Care Airways will contact your physician to get the necessary documents required (based on Medicare guidelines) that prove you qualify for these services in order to bill Medicare, and will continue to do so on a yearly basis. We can only bill as long as your physician facilitates the RX, and progress notes to us. You need to continue to visit your physician on a regular basis for your physician determine that you still need the oxygen therapy.