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Mar 12, 2023

Need New Ostomy Supplier - Recommendations?

Topic Explanation:
The forum topic is about finding a new ostomy supplier for someone's mother who has a colostomy. The current supplier, Medline, will no longer be in network with the mother's insurance starting April 1, 2023. The user is seeking recommendations for a new supplier and also inquiring about any negative experiences with specific suppliers.

Advice and Insights:
- Byram and Comfort Medical are recommended suppliers.
- Edgepark is not recommended due to overcharging, incomplete orders, and billing issues.
- Prism is not recommended unless using Safe n Simple products exclusively.
- 180 Medical does not carry Coloplast products.
- Comfort Medical, Byram, and Nextra are recommended by multiple users.
- Some users have had positive experiences with Liberator Medical and Shield Healthcare.
- It's suggested to call the insurance case manager for a list of in-network providers.
- Different suppliers may specialize in specific product brands, so it's important to check if they carry the specific brand needed.
- Some users have experienced delays in billing and receiving bills from suppliers.
- It's recommended to call the manufacturer for product samples if interested in trying different products.
- Some users have had issues with AdaptHealth PCS, CareCentrix, and McKesson.
- It's advised to verify insurance coverage and billing details with the new supplier.

Billing and Insurance Insights:
- Billing from the supplier will show the amount owed and the list of items in the order.
- A breakdown of what the insurance covered, what is owed, and the cost of supplies will be provided in an explanation letter from the insurance company.
- The supplier typically bills the following month after the supplies are shipped.
- Insurance claims for ostomy supplies can be checked through the online insurance portal to verify payments and claims submitted.
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