To ensure we can bill your insurance, including Medicare, accurately and promptly, please review this information carefully and confirm that you have read and understood the contents.
Your welcome packet includes:
- Customer Satisfaction, Return Policy & Reorder Process
- Patient Bill of Rights
- Rental Agreement, if applicable
- Privacy Practices
- Medicare Standards
Your insurance requires that we have a handwritten or electronic signature on file authorizing DME STATION INC to bill your insurance on your behalf. If this form is not completed, we will be unable to bill your insurance, and you will be responsible for payment of your recent order.