Answers to the questions providers asked about the May 18, 2026 notice: claim filing, reconciliation, member transitions and the new Master Services Agreement.
Synapse Health sent a provider notice on May 18, 2026 announcing network policy updates that take effect June 1, 2026. This article answers the questions providers asked most often about those updates: when claims are due, how the invoice reconciliation window works, what makes a transitioned member payable, and what to expect from the new Master Services Agreement.
These answers apply to all DME providers in the Synapse Health network. If your question is not addressed here, contact your account representative or the DME provider support team.
When the updates take effect and the 60-day claim filing deadline
The updated policies take effect June 1, 2026. All claims must be submitted within 60 days of the date of service. This applies to all claims going forward.
How the date of service is determined
The date of service is the ship date for most mail order, and the delivery date for threshold orders (live deliveries within the home or branch).
How the 30-day invoice reconciliation window works
Synapse will continue issuing monthly invoices covering the prior month’s order activity. Once you receive a statement, you have 30 days to submit the reconciliation.
Only dates of service within the prior 60 days of that invoice will be considered during reconciliation. Claims falling outside this window will not be considered, so it is important to review and respond to statements promptly upon receipt.
| Requirement | Deadline |
|---|---|
| Claim submission | Within 60 days of the date of service |
| Monthly statement uploaded to your ShareFile folder | No later than the 25th of each month |
| Reconciliation submission | Within 30 days of receiving your statement |
| Dates of service eligible for reconciliation | Within the prior 60 days of that invoice |
| Retroactive payment after a patient’s inbound contact | Up to 60 days back from the date of inbound contact |
Where to find your monthly invoice and how to submit a reconciliation
Your assigned Statement Analyst will upload your monthly statement to your Accounts Receivable & Invoices ShareFile folder no later than the 25th of each month.
Complete the Payment Reconciliation tab included in your statement, and ensure all fields are completed prior to submission.
What makes a member transition complete and payable
For all patients transitioning to Synapse Health as the provider of record on or after June 1, the following three criteria must all be satisfied.
Three criteria for a payable transition
All three must be met before Synapse will process payment for transition invoices:
- An up-to-date prescription – the prescription must meet Medicare guidelines
- A delivery ticket – it must meet Medicare proof of delivery requirements and itemize all products expected to be reimbursed
- Successful patient contact by Synapse Health – confirming the patient’s use and continued need for DME
What happens if Synapse cannot reach the patient
If Synapse Health cannot establish contact after four documented attempts, the transition will be placed on hold and the order will be cancelled with a status flag in the system. If the patient later calls in on their own, the transition will proceed immediately.
Payment will not be issued unless and until patient contact is confirmed. However, retroactive payment will apply back up to 60 days from the date of inbound contact.
How Synapse contacts transitioning patients
Synapse Health runs a structured outreach campaign for each transition cohort, making at least four documented contact attempts per member across multiple channels – phone, email, text, and/or letter – over the course of 30 days.
All contact activity is logged with timestamps, and weekly audit-ready reporting is available for supplier review, including contact status, attempt logs, and transition disposition.
The new Master Services Agreement
A new Master Services Agreement (MSA) will be circulated to all providers in the network. The updated agreement establishes a clear framework defining responsibilities for both Synapse Health and its subcontractors. According to the notice, these expectations take effect even without execution of the MSA.
Where to ask a question about the policy updates
If your question is not addressed above, contact your account representative or reach the DME provider support team directly.
DME provider support
Email
dmeprovidersupport@synapsehealth.com
Phone
1.888.33.MYDME
