Answers to the questions DME providers ask most: joining the network, submitting and fulfilling orders, patient transitions, payment and support.
Synapse Health is reimagining the durable medical equipment (DME) experience, making it simpler, faster and better for everyone. We aim to ease the burden on DME providers and prescribers by streamlining ordering and documentation, and help patients by getting them the right equipment from trusted partners.
These questions and answers cover how it all works, from the first conversation about joining the network through order submission, delivery, patient transition and monthly payment.
Partnering with Synapse Health
What are the benefits of partnering with Synapse Health?
Synapse Health’s proprietary digital platform streamlines the DME ordering process, improving efficiency and accelerating fulfillment and delivery. Our transparent technology and communications keep patients informed about their order status, creating a more positive experience.
Synapse qualifies all orders, coordinates with patients, collects co-pays and co-insurance and offers a defined payment schedule based on delivery confirmation. This reduces costs for DME providers and enables them to focus on what they do best: caring for patients and delivering exceptional service.
What services does Synapse Health provide?
Synapse Health offers a digital-first DME solution that eliminates common industry pain points, creating a faster and more accurate experience for all stakeholders. We hold contracts with health plans, act as the provider of record and rely solely on our subcontracted DME provider network for fulfillment and logistics.
What if a DME provider chooses not to join the Synapse Health network?
If a DME provider does not contract with Synapse Health, they cannot bill insurance under the capitated agreement. Patients enrolled in a plan covered under the capitated agreement will be transitioned to Synapse Health for service.
Under the capitated agreement, can DME providers still bill the health plan directly?
No. Under this arrangement, Synapse Health becomes the provider of record and is responsible for submitting all claims to the health plan.
What happens if a patient chooses a different provider?
Synapse Health honors patient choice at all times. If a patient chooses to receive their DME services from another subcontracted DME provider, we shift those services accordingly.
Joining the network and onboarding
How quickly can a DME provider join the Synapse Health network?
The complete enrollment process – including credentialing, contracting, member transition, and onboarding – typically takes less than 45-60 days.
What does the onboarding process involve and how long does it take?
Most DME providers are ready to accept their first order on the Synapse Health platform within 60 days or less. The onboarding process includes credentialing, contracting, membership transition, product training and kickoff meetings with the Synapse Health team to align on implementation steps.
What is the purpose of the kickoff meeting?
The kickoff meeting brings together Synapse Health and the contracted DME provider to review key implementation needs. Synapse Health Network Success Manager presents a tailored onboarding plan to ensure a smooth transition onto the Synapse platform.
Compliance requirements and reporting changes to your organization
What compliance requirements must DME providers meet to partner with Synapse Health?
DME providers must complete an application and business questionnaire; maintain facility and staff licensure; and meet Medicare supplier standards.
How do DME providers update Synapse Health with changes to their organization?
To submit updates, complete the DME Provider Profile Update Form (included in your DME Provider Handbook) and email your Synapse Health Network Success Manager. You will receive a confirmation once the update is processed.
What kinds of organizational changes should be reported to Synapse Health?
Notify Synapse Health of changes in ownership, product offerings, service locations, key staff, contact information or accreditation/license renewals.
Submitting orders to Synapse Health
How are orders submitted to Synapse Health?
Synapse Health offers multiple options for submission, including system of record integrations.
Ways to submit an order
-
Synapse Health Connect portal
connect.synapsehealth.com -
Fax
1.888.690.5329 -
Phone
1.888.33.MYDME -
Email
neworder@synapsehealth.com
Please send email orders from a secure network.
How are UnitedHealthcare in-scope patients identified?
Our Provider Data Team verifies in-scope patients against eligibility and claims file rosters. You can view the current list of in-scope plans at synapsehealth.com/welcome/uhc-providers.
How orders are routed and assigned to you
Where do Synapse Health orders originate?
Orders are received from DME providers, prescribers, skilled nursing facilities and hospitals.
How does Synapse Health decide which DME provider receives an order?
For existing patients, orders are routed back to the DME provider currently servicing the patient. For new patients, Synapse Health uses a proprietary algorithm that considers geography, product type, DME provider performance. If there is an existing relationship and/or a patient preference with a subcontracted DME provider, we will honor that relationship and continue to route orders through that subcontracted provider.
How are orders delivered to DME providers?
Orders are transmitted via the Synapse Health Fulfill portal. Providers receive an email notification and can then log into the portal to view and accept the order.
What information is included in an order?
Each order includes patient demographic information, requested items and quantities, and any applicable documentation (e.g., detailed written orders or prescriptions).
Accepting orders and handling exceptions
What should I do if I accept an order but can’t fulfill it?
Call Synapse Health at 1.888.33.MYDME.
How does Synapse Health handle urgent orders after hours?
Subcontractors are asked for their after hours capabilities during onboarding. Synapse Health has staff available 24/7 and routes these orders accordingly.
Delivery, shipments and proof of delivery
Who coordinates delivery with the patient?
Synapse Health manages all patient communications, including scheduling and support, except for threshold delivery scheduling, which remains the responsibility of the DME provider.
How can DME providers ensure timely delivery of services?
DME providers are expected to follow delivery timeframe guidelines outlined in the DME Provider Handbook.
Can DME providers include their own packing slip in shipments?
Yes. DME providers may use their existing packing slips in shipments and threshold deliveries.
Why might Synapse Health ask for proof of delivery?
If Synapse Health can access proof of delivery (POD) through the tracking number, no additional documentation is required. In cases where the POD is not accessible, we will request a copy of the actual delivery confirmation to process DME subcontracted provider payment.
Products you can offer and patients with active rentals
What products can DME providers offer through the Synapse Health network?
Beginning as early as the contracting phase, Synapse Health works with each DME provider to determine which products they would like to offer within the network. DME providers supply HCPCS information along with details about their service areas and delivery methods.
What happens to patients who have active rentals?
After an agreement is signed, DME providers must submit a list of patients with active rentals along with documentation supporting the continued need for equipment or supplies. These patients will be transitioned to Synapse Health, and the DME provider will be reimbursed for active rentals based on the fee schedule in place.
Patient support: supplies, repairs, returns and prescriptions
What should patients do if they need more supplies, repairs or have an issue?
DME providers should direct patients to contact Synapse Health at 1.888.33.MYDME. A repair or service ticket will be generated as needed within the Fulfill portal.
How does a patient return or exchange equipment?
Patients should contact Synapse Health at 1.888.33.MYDME or engage within the Patient portal for support with returns or exchanges.
If a patient needs a resupply but their prescription has expired, who is responsible for getting the updated script?
Synapse Health will reach out to the patient’s prescriber to request an updated prescription and supporting documentation. If we are unable to connect with the prescriber, we may contact the patient or DME provider for assistance.
Transitioning existing patients to Synapse Health
How are existing patients submitted to Synapse Health?
Contracted DME providers are asked to send an active patient roster. Synapse Health reviews the information and confirms which patients are in scope or out of scope. For in-scope patients, Synapse Health will request that supporting documentation be submitted securely via our Secure File Transfer Portal (SFTP).
What information must DME providers submit for patients transitioning to Synapse Health?
Required information for each transitioning patient
DME providers should verify and submit the following for each transitioning patient:
- Full name and current contact information
- NPI for the provider of rental equipment
- Delivery date and delivery ticket
- HCPCS and descriptions for billable rental items
- Confirmed last billing date and associated billing period
- Diagnosis codes related to the therapy
If additional information is received from a prescriber after the initial transfer, should it be sent to Synapse Health?
Yes. Any updates should be shared with Synapse Health using the appropriate communication channels (Connect or Fulfill portals, or the secure site).
If a patient becomes out of scope with Synapse Health, will they return to the original DME provider?
Yes, unless the patient specifically requests to use another in-network DME provider.
Will Synapse Health provide a list of in-scope patients so DME providers know who remains under their care?
Yes. Once in-scope patients are confirmed, Synapse Health will share a roster and request the necessary documentation for each verified patient.
Who is responsible for obtaining new detailed written orders/prescriptions if the original one becomes invalid?
As the provider of record, it is Synapse Health’s responsibility to obtain new detailed written orders/prescriptions if the order becomes invalid. If we are unable to obtain the necessary documentation, we may contact the patient or DME Provider for assistance.
For non-contracted vendors, Synapse Health will request the necessary information from the previous DME provider or treating prescriber if it has not already been provided.
How do DME providers gain access to your SFTP site for submitting patient transition information?
During onboarding, Synapse Health grants access to selected users identified by the DME provider. If you are already contracted and need assistance, email your dedicated Network Success Manager.
Payment, statements and reconciliation
What are the payment terms and do DME providers need to submit invoices?
DME providers are paid during the fourth week of each month based on the statement issued by Synapse Health. The statement issued by Synapse Health is based on the order documentation and fulfillment status of orders through our portals.
When will DME providers receive a reconciliation statement?
Reconciliation statements are sent during the third week of each month.
When can DME providers expect payment for services?
Payments are issued during the last week of each month.
| What happens | When |
|---|---|
| Reconciliation statement sent | During the third week of each month |
| Payment issued | During the last week of each month |
If there are issues with the statement, who do we contact at Synapse Health?
All questions regarding DME provider statements or invoices should be directed to vendorstatementsconnect@synapsehealth.com.
Portal access, guides and resources
Where can DME providers access resource materials and staff guides?
Visit the DME provider login page on the Synapse Health website. There you will find user guides for Synapse Health portals, the DME Provider Handbook and contact information for Synapse Health departments.
Where should portal access requests for new employees be sent?
Send access requests to your dedicated Network Success Manager, using the portal registration template.
Who should DME providers contact for login assistance?
For login help, contact your Network Success Manager directly.
How can DME providers request more stickers or magnets?
Stickers and magnets are ordered through a quick link on our DME Provider Resource Hub online.
Supporting patients with complex needs
What is the DME provider’s role in supporting complex patients?
DME providers are essential partners in delivering high-quality care for patients with complex needs. Providers in the Synapse Health network are expected to align with our clinical philosophy and contribute to patient outcomes by:
What Synapse Health expects from providers caring for complex patients
- Timely and accurate equipment provision – ensure prescribed equipment is delivered promptly and meets the patient’s clinical needs, in accordance with service level agreements
- Patient education and support – provide clear instructions, training and resources to help patients understand and correctly use their equipment
- Care coordination and patient safety – proactively identify and report patient concerns, safety risks, clinical gaps and care opportunities to improve service and outcomes
- Documentation and evaluation – maintain detailed, accurate records of patient interactions, deliveries and follow-ups to support accountability and continuous improvement
- Quality assurance and compliance – adhere to industry standards, accreditation requirements and Synapse Health policies to ensure patient safety and program integrity
- Data and outcome tracking – participate in performance monitoring and reporting to evaluate program effectiveness and identify improvement opportunities