Question
Hi, Tricia. I order home DME for patients being d/c'd from a 20-bed acute rehab unit. I'm told across-the-board by vendors, that Blue Cross will not cover commodes, yet no one can seem to tell me why. Even Medicare, who doesn't cover bathroom DME, will cover a bedside commode. It's very difficult to explain to a bi-lateral BKA, that their insurance won't provide them a bedside commode. I understand there are a myriad of inividualized coverage plans, however, a commode seems pretty basic. Any thoughts?
Answer
Hi Roger:
I work for a DME company but we do not do to many commode orders however I know that NJ BCBS - Horizon plans pays for them.
Most Blue Cross plans follow Medicare guidelines and Medicare does pay for them however there are some strict guidelines. Plus the reimbursement is pretty low.
So perhaps next time when you get an order call the Blue Cross C/S department and ask them.
I think most will pay.
I know when we bill them to Medicare or other commercial insurance companies the reimbursement is low and it seems to take a long while to get paid. This is why we do not deal with them especially since we have to purchase them from a provider first so we only make a few dollars profit which is not worth us being in that business.
Good Luck!
Tricia
