Attention Medicare Customers

We can process your Medicare order!

If Medicare is your primary insurance, we will need several documents from you and your doctor before we can fill your first order. This process can take two to three weeks to complete; please be aware that we cannot process your order until we have all the requisite paperwork on file. Please have your Medicare card and your physician’s information ready and call 1-800-223-9310. Ask to speak with our Medicare coordinator.

Several required documents are available below.

Medicare Documents to Review  (Click here to view documents.)

•Notice of Privacy Practices

•DMEPOS Supplier Standards

•Bill of Rights

•Description of Services

•Instructions for Use

Medicare Forms to Sign and Return  (Click here to view documents.)                                                                                                    Click Here to submit them to us electronically using our secure portal!

•Admission of Informed Consent: This form confirms that you have received the Medicare Documents to Review (linked above), and that you understand that you are agreeing to receive services provided by Austin Medical Products, Inc., that you understand and have received a written description of services, that you may be required to pay for your services in part or in full, that you authorize us to release medical and other necessary information to Medicare for the claims we submit for you, and that Austin Medical does not accept assignment.

•Medical Record Release Form

•Authorization to Bill Medicare Form

•Product Warranty Form

We must also have:

•A copy of your Medicare Card.

•A prescription(s) that we will request/retrieve from your physician stating your name, diagnosis, a description of the item(s) being prescribed (i.e. AMPatch stoma covers, catheters, lubricant, skin prep., etc.), the number per usage, the number per day, the length of need, the physician’s signature and signature date. This prescription will serve as your physician’s order for Medicare.

•We require adequate medical documentation, which we will request from your physician.  (If you require more stoma covers and/or other supplies than what Medicare routinely covers (see below), we will be seeking additional current medical documentation to substantiate the need for the extra amounts. The documentation must rationalize the need for more than the quantity of supplies normally allowed by Medicare. If you require more than the usual monthly allowance provided by Medicare, Progress Notes (from your medical chart, written by your Healthcare Provider) are the only documentation that Medicare will accept. Without this documentation, your claims will likely be denied as not medically necessary.  Please note: After we receive these documents from you, we will then send you an Advance Beneficiary Notice (ABN) that reflects your physician’s order and is specific to your needs. We must have the signed and dated ABN in our possession before we can fill your order. We anticipate this could take some time so please plan accordingly. We will not be able to supply you with more than what Medicare would normally allow unless all of the necessary documents are filled out completely and we have the originals in our possession.)

Please note: Medicare allows you to order up to a three-month supply at a time.