Medicare

Medicare covers home oxygen therapy when the patient has a pulmonary diagnosis and qualifying test results. These results can be either pulse oxymetry or arterial blood gases (ABG’s).

Medicare will cover a home oxygen concentrator and a portable system. For portable coverage the patient must ambulate within the home.

Oxygen equipment is paid for monthly, for 36 months as a “capped rental”. After the 36th month the patient may keep the equipment for as long as it is medically necessary. The equipment may be replaced after month 60. See the OXYGEN BULLETIN in this menu for more info.

After month 36 portable oxygen contents are paid for on a monthly basis, when needed.

This new payment system from Medicare has caused problems for patients who desire to move or change providers (snow birds for example). These patients are unable to find a provider who will accept them once they have use the majority of their billable months.

In addition, after month 36 these patients may have difficulties getting cylinders refilled.

At Diamond we have developed a system that solves these issues. We have a travel program that has taken oxygen patients around the world. Also, we have our own oxygen filling plant that allows us to get as portable much oxygen to your patients as they need.


Medi-Cal

Medi-Cal covers oxygen for patients who have a pulmonary diagnosis and qualifying test results. Medi-Cal requires an Arterial Blood Gas test (ABG) with a PO2 result of 55 or below.

Medi-Cal requires that the physicians order and the test results go through their Treatment Authorization Request (TAR) process. Diamond will deliver the equipment to your patient, and deal with the TAR process. We’ll just need your prescription and test results.


Other Insurance (PPO / HMO)

Most PPO and HMO plans require an authorization for oxygen therapy. Each differs according to their own rules. In general the patient must have a pulmonary diagnosis and either a pulse oxymetry test or an ABG.

We’ll handle all of the paperwork and authorizations. Simply send us your prescription, and test results. We’ll do the rest!