New DME order process with Synapse Health
We now have a capitated arrangement with Synapse Health for standard durable medical equipment (DME) in Georgia and North Carolina. This new arrangement applies to UnitedHealthcare® Medicare Advantage plan members enrolled in HMO and PPO products.
We understand this is a change to our existing provider network and to the current DME ordering and fulfillment processes. However, considering feedback from providers and members, we recognized an opportunity to improve the experience for everyone – ordering physicians, DME suppliers and members.
What this means for you
DME prescribers
As of Aug. 1, 2024, you should prescribe DME through Synapse Health’s e-prescribing portal. The Synapse Health prescriber adoption team will connect with you over the next few months to answer any questions. You can also schedule 1-on-1 trainings, or view online self-help tools.
For patients who need continuous DME services after Aug. 1, 2024, Synapse Health will work with existing DME providers to maintain the patient or transition to a new DME provider. Synapse Health may connect with you if a new order or documentation is required to support the patient’s ongoing DME needs or plan of care.
DME providers
If you are a DME provider, you will need to join the Synapse Health network to continue to provide standard DME for most UnitedHealthcare Medicare Advantage Plan members in Georgia and North Carolina. Synapse Health will reach out to you with details about joining their network, or you can contact Synapse at JoinOurNetwork@synapsehealth.com.
What’s included in this change
This new arrangement will apply to the following mail order supplies and standard DME products:
- Diabetic supplies
- Enteral
- Home ambulatory
- Hospital beds
- Insulin therapy
- Mobility aids
- Negative pressure wound therapy
- Ostomy
- Oxygen
- Respiratory
- Respiratory vest
- Sleep
- Urological
- Ventilators
- Wheelchairs – standard
- Wound care
What’s not included with this change
This new arrangement won’t apply to the following products:
- Bone growth stimulators
- Cancer treatment
- Cardiac defibrillators
- Complex rehab
- Optune device
- Oral devices
- Orthotics
- Parenteral nutrition, vision and hearing
- Prosthetics
This new arrangement also won’t apply to the following Medicare Advantage plans:
- Dual Special Needs Plans (D-SNPs)
- Chronic Special Needs Plans (C-SNPs)
- Institutional Special Needs Plans (I-SNPs)
- Institutional Equivalent Special Needs Plans (IE-SNPs)
- Group retiree plans
Questions?
- Online: Visit Synapse Health's website
- Phone: Call Synapse Health at 888-336-9363
PCA-1-24-00798-UHN-NN_04222024
