Insurance & Billing Disclosure

HBG Health

HBG Health works with Medicare, Medicaid, and many commercial insurance plans to provide durable medical equipment (“DME”). This page explains how insurance billing works and outlines patient financial responsibilities.

Please review this information carefully before placing an order or accepting equipment.

Insurance Coverage Is Not Guaranteed

  • Insurance coverage for medical equipment is not guaranteed.

  • Coverage decisions are made solely by your insurance provider

  • Benefits vary by plan, diagnosis, and medical necessity

  • Submission of insurance information does not guarantee payment

  • HBG Health is not responsible for coverage determinations made by insurance providers.

Patient Financial Responsibility

By submitting insurance information or accepting equipment, you acknowledge and agree that you are financially responsible for:

  • Deductibles

  • Copayments

  • Coinsurance

  • Non-covered items or services

  • Charges denied by insurance

  • Upgrades or optional features not covered by insurance

  • If insurance denies or partially pays a claim, the remaining balance is the patient’s responsibility.

Medicare & Medicaid Billing

For Medicare and Medicaid beneficiaries:

  • Claims are submitted in accordance with payer guidelines

  • Medical necessity documentation may be required

  • Coverage is subject to local and national coverage determinations

  • Rental vs. purchase decisions are governed by Medicare rules

  • Medicare and Medicaid do not allow returns for convenience once equipment is dispensed.

Rentals vs. Purchases (CPAP & Related Equipment)

  • Some equipment, including CPAP devices, may be billed as a rental before ownership transfers.

  • Rental periods and ownership timelines are determined by insurance

  • Compliance requirements may apply during rental periods

  • Failure to meet compliance requirements may result in discontinued coverage

  • Patients remain responsible for charges incurred during the rental period.

Documentation Requirements

Insurance providers may require:

  • A valid prescription

  • Physician documentation

  • Proof of medical necessity

  • Compliance or usage data

  • Delays or denials may occur if required documentation is incomplete or not provided.

Non-Covered & Cash-Pay Items

  • Some products and services may not be covered by insurance.

  • Non-covered items may be offered as cash-pay

  • Payment is required prior to shipment for cash-pay items

  • Cash-pay purchases are subject to our Returns & Exchanges Policy

Claim Adjustments & Denials

Insurance claims may be:

  • Adjusted

  • Partially paid

  • Denied

In such cases:

  • Patients will be notified of the balance due

  • Payment is required according to HBG Health’s billing terms

  • HBG Health may bill secondary insurance if provided, but payment is not guaranteed.

Changes in Coverage

Insurance coverage may change at any time due to:

  • Plan changes

  • Employer changes

  • Eligibility updates

  • It is the patient’s responsibility to notify HBG Health of insurance changes.

Questions & Billing Support

If you have questions about insurance or billing, please contact us:

support@hbghealth.com

Acknowledgment

By placing an order, submitting insurance information, or accepting equipment from HBG Health, you acknowledge that you have reviewed and understand this Insurance & Billing Disclosure and agree to the terms outlined above.