What Synapse Health needs from network providers to move transition orders to a payable status, plus PAP compliance access, equipment issue reporting, and claims routing for in-scope UnitedHealthcare plans.
Member transitions
Per the Member Transition Guidelines detailed in our Network Policy Update FAQs, orders do not move to a completed or payable status until Synapse Health confirms direct patient contact verifying that the equipment is in the home and that the patient understands their rental transitioned to Synapse Health billing effective June 1, 2026.
You continue to own service delivery and the patient relationship. This is a documentation requirement.
Getting reimbursed for transition patients
Patient contact is one of three criteria, and all three must be met before a transition invoice is processed.
Required before a transition invoice is paid
- Standard written order (SWO) – it does not need to be current. If the SWO is expired, we will process the order and follow up to refresh it.
- Delivery ticket – must meet Medicare proof of delivery requirements and itemize every product expected to be reimbursed.
- Patient contact – successful contact by Synapse Health confirming the patient’s use and continued need for the equipment.
See who still needs a member transition
Review the weekly export sent to your designated Member Transition contacts, or check the Onboarding Status and Missing Documents columns in Fulfill.
Fastest way to transition a member
Warm transfer the patient to Synapse Health at 888.651.2304 while you have them on the phone. This is the preferred onboarding method.
PAP compliance access and proof of education
Manufacturer constraints prevent Synapse Health from adding or tagging itself in PAP compliance platforms, and we cannot tag prescribers either. For every PAP patient, tag Synapse Health so we can view compliance.
What we need on PAP orders
Every PAP order needs one of the following two things. Tagging Synapse Health at setup is the simplest way to cover it.
- A compliant adherence download – provided to Synapse Health.
- Platform access – access to the patient in the corresponding platform, such as AirView, React Connect, CareOrchestrator, or the equivalent for that device.
Proof of education is required for all new PAP setups. Use the Virtual CPAP Home Safety Assessment and Patient Education form, also available in the Deliver portal. Your own form is acceptable if it meets compliance requirements.
Lost, stolen, or broken equipment and pick-ups
- Lost, stolen, or broken equipment: submit a note in the Fulfill portal. Our RCM team reviews and processes the request from there. Learn more in the Lost, Stolen, or Broken Equipment guide.
- Pick-ups: your monthly statement from Synapse Health includes a Pick Up tab. Add the pick-ups you completed that month so our records match yours and your reimbursement is accurate.
Claims routing for in-scope UnitedHealthcare plans
Under our capitated arrangement with UnitedHealthcare, Synapse Health holds financial responsibility for DME and supplies furnished to patients enrolled in our in-scope plans. Claims for those patients route through Synapse Health, not directly to UHC.
Plan rosters shift and new capitated arrangements come online regularly, so check the current reference before an order is placed.
- Routing: route orders and billing through Synapse Health for any patient enrolled in a Synapse in-scope UHC plan, rather than billing UHC directly.
- Reference: the Capitated Health Plans list is organized by state and updated in real time. Share it with your intake, ordering, and billing teams.
Who to contact
-
Patient transitions (warm transfer)
888.651.2304 -
Patient at immediate risk
888.336.9363 -
DME Provider Support
dmeprovidersupport@synapsehealth.com
