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Want to submit your purchase to your insurance provider?

1800CPAP.com provides you with the HCPCS codes associated with the products we offer. We also will provide you with the Insurance Out of Network Claim Forms you will need when submitting your claim. We understand filling out confusing paperwork is frustrating and knowing the HCPCS codes, which insurance claim form to use and what diagnosis codes to use will expedite the process. Not sure which HCPC Code, Diagnosis Code or which claim form to use? Just email us at customersupport@1800CPAP.com Below is a step by step process on how to submit your claim to the insurance!

Please Note: These HCPCS codes are provided as a reference guide only, always verify with your health insurance provider to guarantee accuracy. Health insurance providers may have different policies and procedures for accepting successful claims. Please contact your health insurance provider directly (phone number is usually located on back of your insurance card) to determine which procedures you should follow to guarantee a successful claim. To learn more about HCPCS codes visit the Centers for Medicare & Medicaid Services.


Step One: Find your Insurance's Out of Network Claim Form!


The first thing you want to do is find your insurance companies out-of-network claim form. Once you have located it below, you will need to print the form and complete all fields. If you do not complete the claim in its entirety, you risk a delay in getting your claim processed by your insurance company. After you have located and printed your claim form, move on to Step 2.


  1. Anthem- OH, KY, IN, MO or WI Out-of-Network Health Insurance Claim Form     Download Claim Form
  2. Anthem- Colorado or Nevada Out-of-Network Health Insurance Claim Form     Download Claim Form

  3. Anthem- Virginia Out-of-Network Health Insurance Claim Form     Download Claim Form

  4. Anthem- New Hampshire Out-of-Network Health Insurance Claim Form     Download Claim Form

  5. Anthem- Connecticut or Maine Out-of-Network Health Insurance Claim Form     Download Claim Form

  6. Humana Out-of-Network Health Insurance Claim Form     Download Claim Form

  7. Cigna Out-of-Network Health Insurance Claim Form     Download Claim Form

  8. United HealthCare Out-of-Network Health Insurance Claim Form     Download Claim Form

  9. Aetna Out-of-Network Health Insurance Claim Form     Download Claim Form

Step Two: Completion of your Insurance's Out of Network Claim Form!


This part is fairly self explanatory! You will need to complete all of your personal demographics (Name, Address, Date of Birth, Member ID, etc.) and this pertains to all claim forms. The areas you may need help with regarding our information and others are as follows:

  1. Provider's Name
  2. Provider's Tax ID
  3. Provider's Address
  4. Place of Service Code
  5. Diagnosis Code
  6. Date of Service
  7. Description of Goods
  8. Quantity of Goods
  9. Charges of Goods; per item and total
  10. Procedure Code or HCPCS Codes

Description and answers for the above key areas that need filled in on your form:


  1. Provider's Name: Ohio Sleep Awareness, LLC 1800CPAP.com is the dba for the Legal Entity Ohio Sleep Awareness!
  2. Provider's Tax ID: 26-0504270
  3. Provider's Address: 651 Reading Rd. Mason, OH 45040
  4. Place of Service Name or Code: Name would be HOME and Code would either be 12 or otherwise defined on your clami form.
  5. Diagnosis Code: 327.23
  6. Date of Service: Date you purchased the goods/ Invoice date
  7. Description of Goods: You will have to line item each part you received. i.e. Mask with Headgear would be line #1: Mask and line #2 Headgear
  8. Quantity of Goods: Quantity of each line item
  9. Charges of Goods; per item and total: Paid amount for each line item; Total will be all line items totalled at the bottom of your form
  10. Procedure Code or HCPCS Codes: These codes can be found by using your Invoice and the list of HCPCS Codes listed below with definitions. You will want to make sure you refer to both your Invoice as well as the list we provided you below!

 

CPAP, Bi-Level, Bi-PAP MACHINE INSURANCE (HCPCS) CODES

E0601

Continuous airway pressure (CPAP/APAP) device

E0470

Respiratory assist device, Bi-Level pressure (Bi-PAP) capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)

E0471

Respiratory assist device, Bi-Level pressure (Bi-PAP) capability, with backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)

E0472

Respiratory assist device, Bi-Level pressure (Bi-PAP) capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)

E0561

Humidifier, non-heated, used with positive airway pressure (CPAP/Bi-PAP/APAP) device

E0562

Humidifier, heated, used with positive airway pressure (CPAP/Bi-PAP/APAP) device

 

 

CPAP, Bi-Level, Bi-PAP MASK INSURANCE (HCPCS) CODES

A7030

Full Face Mask used with Positive Airway Pressure (CPAP/Bi-PAP/APAP) device

A7034

Nasal interface (mask or cannula type) used with positive airway pressure (CPAP/Bi-PAP/APAP) device , with or without headgear

A7044

Oral interface used with positive airway pressure (CPAP/Bi-PAP/APAP) device

K0553

Combination oral/nasal mask, used with continuous positive airway pressure (CPAP/Bi-PAP/APAP) device

 

 


NEW CODE Alert: A4604 Tubing with integrated heated element for use with positive airway pressure device


CPAP, Bi-Level, Bi-PAP PART & ACCESSORY INSURANCE (HCPCS) CODES

A7032

Replacement Cushion for Nasal or Full Face Mask

A7033

Replacement Pillows for Nasal Mask

A7035

Headgear used with positive airway pressure device

A7036

Chinstrap used with positive airway pressure device

A7037

Tubing used with positive airway pressure device

A7038

Filter, disposable, used with positive airway pressure device

A7039

Filter, non-disposable (reusable), used with positive airway pressure device

A7045

Exhalation port with or without swivel used with accessories for positive airway pressure devices

A7046

Water chamber for humidifier, used with positive airway pressure device

E1399

Miscellaneous Durable Medical Equipment Items, Components and Accessories

K0554

Oral cushion for combination oral/nasal mask

K0555

Nasal pillows for combination oral/nasal mask

 


LIGHT THERAPY DEVICE INSURANCE (HCPCS) CODES

E0203

Light Therapy Device

 

 


Step Three: Signing and Mailing your Insurance's Out of Network Claim Form!


Review your form for accuracy because if there is anything that is not accurate or correct, you will want to fix it prior to mailing your form. Remember that everything must be accurate in order for you to have a chance for your insurance company to accept your Out-of-Network claim! Once you have reviewed the claim and are comfortable with the information you have filled out, Sign and date the form.


MAKE SURE YOU INCLUDE YOUR INVOICE FROM 1800CPAP.COM WHEN SUBMITTING YOUR CLAIM FORM


Mailing your form will now take place and most forms will have the address on the form. Here is address' for the companies just in case:


  1. Anthem- OH, KY, IN, MO or WI:  Anthem Blue Cross and Blue Shield  PO Box 105187  Atlanta, GA  30348
  2. Anthem- Colorado or Nevada:  Anthem Blue Cross and Blue Shield  PO Box 5747  Denver, CO  80217-5747
  3. Antem- Virginia:  Anthem Blue Cross and Blue Shield  PO Box 27401  Richmond, VA  23279-7401
  4. Anthem- New Hampshire:  Anthem Blue Cross and Blue Shield  PO Box 533  North Haven, CT  06473-0533
  5. Anthem- Maine or Connecticut:  Anthem Blue Cross and Blue Shield  PO Box 533  North Haven, CT  06473
  6. Humana:  Mail to: Address on the back of your insurance card!
  7. Cigna:  Mail to: Cigna Behavioral Health  Attn: Claims Service Dept.  PO Box 46270  Eden Prairie, MN  55344-6270
  8. United HealthCare:   Mail to: United Healthcare of the River Valley  PO Box 5230  Kingston, NY  12402-5230
  9. Aetna:  Mail to: Address on the back of your insurance card!