Billing FAQs

We’re committed to making your care easy to access and simple to manage. We accept most major insurance plans—including HMOs, PPOs, Medicare, and Medicaid. If you’d like to confirm your plan, check out our state-by-state list of accepted insurance. Still unsure or need help understanding your benefits? 

Our team is here to help. Please visit our Contact page and select Billing to connect with our Billing team.

At Performance Home Medical, we’re committed to making your care easy to access and simple to manage. We accept most major insurance plans—including HMOs, PPOs, Medicare, and Medicaid.

If you’d like to confirm your plan, check out our state-by-state list of accepted insurance. Still unsure or need help understanding your benefits? Our team is here to help.

A deductible is the amount your insurance company requires you to pay out of pocket before they begin covering services. Once you meet your deductible, your insurance will start paying its portion of the costs. Most deductibles renew at the beginning of the calendar year, so they start over each January.

Co-insurance is the percentage of the cost you’re responsible for after your deductible is met. For example, if your insurance covers 80% of a service, you would be responsible for the remaining 20%. This applies until you reach your plan’s out-of-pocket maximum.

A copay is a set dollar amount you pay for certain services or supplies, such as a doctor visit or a monthly rental fee. Unlike co-insurance, which is a percentage, a copay is a fixed amount determined by your insurance plan. Copays usually apply even after your deductible is met and can vary based on the type of service you receive.

Most insurance plans require patients to pay part of the cost for their equipment or supplies. Autopay makes handling these payments simple and stress-free. Once your insurance processes a claim and determines your portion, any remaining balance for rentals or supplies is automatically applied to the card or bank account you provided. You’ll get an invoice by email showing your balance. This helps ensure your payments stay up to date so your therapy can continue without interruption. Autopay is secure, convenient, and widely used by medical equipment companies and other health care providers to make billing easier for patients.

Autopay is simple, secure, and saves you time — no more mailing payments or calling in each month. Your payment information is entered directly into our secure Autopay portal and is never stored in our office systems.

• Before you receive equipment or services, you’ll be added to the Autopay portal and asked to enter your preferred payment method.
• After your insurance pays its portion, you’ll get an invoice by email showing your balance. This is the balance that you owe. You have 10 days to contact our Billing Department at 866.905.2455 to change your method of payment for this one transaction otherwise we will bill your card/check.
• Invoices will come from “HME Bill Pay.”

Most insurance companies pay a portion of the cost for your medical equipment, and the remaining amount is the patient’s responsibility. Since device rentals are usually billed monthly over a 10–13 month period, Autopay helps ensure your portion is paid on time so your therapy can continue without interruption. It also saves you the hassle of mailing payments. Autopay is secure, convenient, and designed to make staying on therapy as easy as possible.

Your out-of-pocket costs depend on what your insurance company allows for the services you receive. If you have secondary insurance, it will work with your primary plan and may help reduce what you owe. After your claim is processed, your insurance company will determine the portion that is your responsibility. If you’d like examples of estimated out-of-pocket expenses, please call us at 866.905.2455 or please visit our Contact page and select Billing to connect with our Billing team.

Equipment rental requirements are determined by your insurance plan.

The equipment you receive is not a trial. It will be billed to your insurance and processed using your current benefits. Compliance requirements may apply after the first 90 days.

Your first invoice is usually higher because it includes the cost of your supplies and the humidifier. Most insurance plans purchase the humidifier up front, and all supplies are billed as purchases, not rentals. After that, your monthly rental invoices should be lower.

You can use our secure Patient Portal to view your invoices and make payments anytime. You can also register for Autopay to have your balance paid automatically after insurance processes your claim, and choose eDelivery to get your invoices by email instead of mail. You may cancel at any time.

Invoices include multiple sections that outline services, billing codes, and payment activity. Have questions? Our team is here to help. Please visit our Contact page and select Billing to connect with our Billing team.

Check the top-right corner of your invoice under “Total Insurance Pending.” This section shows how much was billed to your insurance. Have questions? Our team is here to help. Please visit our Contact page and select Billing to connect with our Billing team.

Even with automatic payments, we send monthly statements for your review. To switch to digital notifications or paperless statements, update your settings in the Patient Portal. Have questions? Our team is here to help. Please visit our Contact page and select Billing to connect with our Billing team.

If equipment was returned after the monthly billing date, you may still see a charge for that month. Your next bill should reflect the return.

To request an itemized bill, please visit our Contact page and select Billing to connect with our Billing team.

Invoices reflect services rendered in the prior month. A balance is only past due if noted as such on your current bill.

We do our best to provide an accurate estimate before your services begin. However, the final amount you owe is determined during the insurance claims process, and several factors can affect it:

• Coverage varies by plan and individual benefits. Your insurance may allow more or less than what was originally estimated, which can change your portion of the cost.
• Secondary insurance coordination. If you have more than one insurance plan, additional adjustments may be made once both plans process the claim.
• Additional services or supplies. If you receive more items during your care, your total cost may increase.
• Claim processing differences. Insurance companies vary in how they process claims and how long it takes, which can impact the final balance.

If you’d like to review your account, we’d be happy to help! Please visit our Contact page and select Billing to connect with our Billing team.

Please contact the Customer Service Department at 866.687.4463 or email orders@performancehomemed.com and we’ll coordinate a pickup and update the patient record with the necessary information.

Your equipment helps you stay healthy, and it’s important to understand the steps you need to take to continue qualifying for coverage for your device and supplies.

What’s Covered

• Most insurance plans—including HMOs, PPOs, Medicare, and Medicaid—cover equipment such as PAP devices, oxygen, and ventilators.
• Insurance usually covers equipment if it’s intended for regular, ongoing use. To maintain coverage, insurers may require you to show that you are using your equipment as prescribed by your health care provider.
• Some devices automatically track your usage and send that information to your supplier.
• Some insurers, including Medicare, may require follow-up visits with your provider to confirm your treatment is still effective and medically necessary.
• Always check with your insurance company to understand their specific requirements. If you don’t meet required usage or follow-up visit guidelines, you may be responsible for paying for your equipment out of pocket.

For a better understanding of how these guidelines apply in your state, use the links below:

• Idaho Medicare & Medicaid PAP Coverage Requirements
• Oregon Medicare & Medicaid PAP Coverage Requirements
• Washington Medicare & Medicaid PAP Coverage Requirements

Why Regular Use Matters

• Insurance usually covers DME only if it’s intended for regular, ongoing use. This often means proving you use your equipment daily and as directed by your provider.
• Some devices automatically track your usage and send that information to your supplier. Others may require you to record and submit your usage yourself.
• Always check with your insurance company to understand their specific requirements.

Staying on Track

• Some insurers, including Medicare, may require follow-up visits with your provider to confirm your treatment is still effective and medically necessary.
• If you don’t meet required usage or follow-up visit guidelines, you may be responsible for paying for your equipment out of pocket.

Medicare, Medicaid, and most HMOs and PPOs follow specific PAP compliance guidelines during the first 90 days. These requirements must be met to continue using—or to purchase—your PAP device after the initial three-month period. To view our PAP Replenishment Guide click here.