How do I send a referral?

Fax your order and supporting chart notes to (800) 438-2048. Include patient demographics, face-to-face and Standard Written Order where required, and relevant test results. Or call (800) 977-3002 to set up EMR ordering.

What must the order include?

Patient name/DOB, equipment requested, qualifying diagnosis, ordering provider signature and date, and supporting chart notes including face-to-face where needed.

Clinicians → Referrals

How to send an order

Fax to (800) 438-2048 or send through your EMR — we confirm receipt and next steps by phone. Include everything below so we can deliver without rework. EMR setup: (800) 977-3002

Need a cover sheet? One-page fax cover with checkboxes — reduces rework.Download cover sheet ↓

Includes: referring provider/NPI, patient demographics, purpose (new/add/replacement/coverage question), equipment/ICD-10, urgency, discharge facility/date, attachments checklist (SWO, face-to-face, chart notes, test results), page count.

What to include — by scenario

One undifferentiated checklist causes over- and under-sending. Pick the scenario that matches the order.

New oxygen setup

SWO: liter flow and hours of use, signed & dated, with NPI
Face-to-face note addressing hypoxemia/qualifying condition
Qualifying saturation testing (oximetry) — room-air where required
Demographics + ICD-10

PAP (CPAP / BiPAP)

SWO: pressure settings, signed & dated
Face-to-face note
Sleep study results
Demographics + ICD-10

Hospital bed

SWO: bed type, signed & dated
Face-to-face note documenting medical need (positioning, pressure injury risk, etc.)
Supporting chart notes

Manual wheelchair

SWO: chair type, signed & dated
Face-to-face + MRADL documentation
Home assessment notes (doorways, access)

Support surface (low air loss / advanced)

SWO: surface type, signed & dated
Face-to-face + wound/stage documentation
Prior authorization — send clinical documentation up front

Verify against current LCD/payer policy — call (800) 977-3002 and we'll check it with you.

What to include

Patient demographics (name, DOB, address, phone, insurance)
Equipment / supply requested with qualifying diagnosis
Face-to-face note where required (see checklists)
Standard Written Order (SWO) — signed & dated
Supporting chart notes / test results (oximetry, sleep study, etc.)

Face-to-face & SWO — quick check

Coverage is documentation-sensitive. See our library pages for product-specific checklists — a human must verify LCD numbers before relying on them.

Face to face & SWO →Face-to-face for DME claims →Medicare DME order requirements →Working with DME suppliers →

What happens next

We review for completeness and coverage
We contact patient to schedule delivery/setup
We deliver, set up, and teach in the home
We handle billing and any payer correspondence

Need to check status? Call (800) 977-3002.

Referral fax: (800) 438-2048 · Phone: (800) 977-3002Product formulary