DME Subcontractor Handbook

Welcome to the Synapse Health Subcontractor Network

Welcome to the Synapse Health DME Subcontractor Network. We’re glad you’re here — and we’re committed to making this partnership work well for your team and the patients you serve.

Synapse Health was established in 2016 to address the fragmented DME ecosystem. Our digital platform reduces the time and complexity involved in ordering, fulfilling, and delivering DME — so subcontractors can focus on what they do best: getting the right equipment to patients, on time.

As the supplier of record, Synapse qualifies orders, manages patient coordination, collects co-pays and co-insurance, and pays your organization once delivery is confirmed and documentation is received. That means less administrative work for your team and more predictable operations.

This handbook is your operational guide. It explains your responsibilities as a subcontractor, outlines how key processes work, and tells you where to go when you need help. Synapse Health will provide at least 30 days’ notice before any material changes to this handbook.

For the most current information, visit the DME Provider Resource Hub at
synapsehealth.com/dmeproviderresources.

Our Mission, Vision & Values

Mission: To streamline the DME experience — remove barriers, improve accountability, and deliver solutions that work better for everyone.

Vision: To redefine how DME works through continuous innovation.

Our Values:

• One Team, One Mission — We align across teams and functions. As trusted partners, we work toward shared goals.
• Purpose-First — We’re here to make a difference through more efficient, patient-centered care. Integrity, humility, and follow-through are non-negotiable.
• Earn Trust with Every Interaction — We lead with transparency, design with empathy, and execute with clarity.
• 1% Better Every Day — We challenge the status quo, stay agile, and create space to learn fast.

Performance Standards for Subcontractors

All subcontractors in the Synapse Health network are credentialed prior to contracting and are expected to maintain high standards throughout the partnership. Key expectations include:

• Maintaining required licensure and accreditation at all times
• Providing high-quality, compassionate care to patients
• Maintaining 24-hour on-call coverage, 7 days per week, for life-sustaining equipment (oxygen, vents, PAP, etc.)
• Being open to the public a minimum of 30 hours per week during normal business hours
• Reporting emergency location closures immediately to 1.888.801.9449
• Collecting and submitting all required delivery documentation, including equipment make/model, serial numbers, modem numbers, and patient signatures
• Using trained — and where required, licensed — professionals to deliver, set up, and service equipment
• Ensuring all product and delivery information submitted to Synapse is accurate and complete
• Responding to patients’ linguistic, cultural, and other unique needs with respect
• Accepting payment from Synapse Health as payment in full (no separate claims to payors, no balance billing to patients)

Inventory, Orders & Delivery

Inventory Maintenance

Subcontractors are expected to maintain adequate inventory to reliably fulfill DME orders. All inventory must be stored appropriately, in accordance with manufacturer guidelines and applicable regulations. Subcontractors are solely responsible for inventory that is lost, damaged, or destroyed during storage.

Order Notification & Response Times

When an order is available in the Fulfill portal, registered users will receive an email notification. Subcontractors are responsible for ensuring that adequate staff monitor email and the Fulfill portal during business hours and after hours, including weekends and holidays.

Response Time Requirements

Delivery Types & Confirmation

Shipping/Mail Delivery — Items are packaged and sent via postal or express carrier (FedEx, UPS, etc.). Subcontractors must log shipping details — including drop-off date, delivery date, carrier name, and tracking number — directly in the Fulfill portal.

Threshold/In-Home Delivery — Larger or more complex items are delivered directly to the patient’s home. Qualified personnel provide setup and patient education at delivery. An electronic delivery packet is completed through the Deliver portal. Both the patient and delivery technician sign electronically, confirming delivery, setup, and training with a time/date stamp.

Urgent Requests — Synapse Health assesses and coordinates all urgent matters. During business hours, urgent requests follow the standard notification process plus a phone call. After hours, Synapse contacts the subcontractor’s on-call contact.

• Respond to Synapse within 60 minutes of receiving the request
• Complete delivery within 4 hours
• Call Synapse immediately if a delay exceeding 2 hours is anticipated

Cancelling Orders

If an order cannot be filled, subcontractors must immediately reject it in the Fulfill portal. If the portal rejection isn’t possible, contact the DME Provider Line at 1.888.801.9449

Equipment Pickup

Synapse Health notifies subcontractors of pickup needs via a pickup ticket in the Fulfill portal.

• Purchased equipment will not be picked up from the patient. Synapse Health advises the patient directly.
• Rental equipment: If a patient no longer needs rental equipment, Synapse issues a pickup ticket. Subcontractors should prioritize pickup within the patient’s preferred window. No separate pickup fee is issued — it is included in the lease fee.

Equipment Returns & Refusals

If a patient refuses equipment at delivery, contact Synapse immediately at 1.888.801.9449. Synapse will not reimburse for refused or returned items.

For mail-order returns within 14 days, a pickup ticket will be issued. The subcontractor must supply return packaging, a shipping label, and instructions, then notify Synapse when the returned product is received and confirm it is unopened and resale-ready.

Patient Walk-In Orders

If a patient visits a subcontractor location with a prescription and their insurance payor is contracted with Synapse Health, the subcontractor should:

• Enter the order into the Connect portal immediately, including the signed prescription and any other documents the patient provides
• Advise the patient that Synapse Health is processing the order and will contact them within 2 business days
• Share Synapse Health’s patient phone number with the patient: 1.888.336.9363

Maintenance & Repairs

Equipment Maintenance

Before distributing any DME item — and while rental equipment is in use — subcontractors must ensure items are maintained in accordance with preventive maintenance schedules, manufacturer guidelines, and applicable regulations. Maintenance records must be kept on file and provided to Synapse upon request. All maintenance fees are included in the monthly payment from Synapse Health.

Equipment Repairs & Service Calls

Synapse Health coordinates all DME repairs and service calls. At delivery, subcontractors affix the Synapse Health sticker to rental equipment — it includes the Patient Portal link and Customer Service phone number.

When a service call is needed, Synapse creates a service ticket and shares it with the subcontractor. The subcontractor confirms availability and conducts the assessment or repair as needed. Replacement items may not be separately reimbursable — refer to your Subcontractor Agreement.

Product Recalls

Subcontractors must maintain a tracking log of all equipment, including model, serial or lot numbers. Subcontractors are responsible for monitoring FDA and manufacturer recall notices and must report any recalls — along with a list of affected patients — to Synapse Health within one calendar day of becoming aware of the recall.

Patient Transitions

At times, a subcontractor may have patients with active DME rentals who transition to Synapse Health as the supplier of record. This section outlines how that process works.

Provider of Record Transition

When a current supplier becomes subcontracted with Synapse Health, patient care and management shift to Synapse Health as the new provider of record.

Required Documentation

To enable a smooth transition, subcontractors must provide qualifying documentation using the required Patient Transition Template. This allows Synapse to accurately assume the provider of record role and ensures subcontractors continue to receive payment for rentals and resupply orders during the transition period.

If a resupply order comes due during the transition, do not delay fulfillment. Invoice Synapse Health in accordance with your usual practices.

Transfer Coordination

Synapse Health has a dedicated Patient Transition Team to support subcontractors through this process. Failure to provide required patient lists and records by the agreed date may result in delayed payments. Documents are uploaded via a secured ShareFile portal. To request access changes, email dmeprovidersupport@synapsehealth.com.

Managing Your Provider Profile

Keeping your profile current ensures you continue to receive orders and that coordination runs smoothly. Submit updates using the DME Provider Profile Update Form and email it to dmeprovidernetwork@synapsehealth.com.

Patient Support Programs & Clinical Expectations

The Synapse Health Philosophy

Synapse Health’s programs are designed to enhance patient outcomes, improve quality of life, and support the appropriate use of DME. High-quality service goes beyond equipment — it requires personalized support, quality oversight, continuous education, and strong care coordination.

Your Role in Supporting Clinical Programs

As a subcontractor, you contribute to patient outcomes by:

• Ensuring timely and accurate equipment delivery based on clinical need
• Providing clear patient education and training at the point of delivery
• Maintaining documentation and reporting to support accountability
• Participating in adherence monitoring programs where applicable
• Proactively identifying and reporting patient concerns, safety issues, or care gaps

Adherence Monitoring

For certain DME categories — including CPAP and BiPAP — subcontractors may, by mutual agreement with Synapse, perform adherence monitoring to support ongoing medical necessity and treatment effectiveness. Subcontractors performing adherence monitoring must provide Synapse with access to adherence data and must address non-adherence through ongoing patient education. If extended non-adherence renders equipment ineligible for coverage, Synapse Health must be notified and payment may be suspended until compliance resumes.

Key Performance Indicators

At each Joint Operating Committee (JOC) meeting, subcontractors receive KPI data used to assess performance and guide improvements.

KPIs at a Glance

Onboarding & Training

Getting Your Team Set Up

Before accepting orders, all subcontractors complete a comprehensive onboarding process covering the Connect, Fulfill, and Deliver platforms. Key staff responsible for accepting and fulfilling orders must attend onboarding training. To add or remove portal users, email dmeprovidersupport@synapsehealth.com.

Ongoing Training & Support

The DME Provider Resource Hub includes user guides for the Fulfill and Deliver portals, important forms, and up-to-date contact information.

Payments

How Payments Work

Synapse Health reimburses subcontractors based on their contracted fee schedule for fulfilled and delivered orders. At the end of each month, Synapse queries its system for completed orders to generate a payment statement. Statements are uploaded to a secured ShareFile portal in the third week of the month. Payment is deposited electronically in the fourth week.

Reconciliation

Credentialing & Recredentialing

Initial Credentialing

All subcontractors and service locations must meet credentialing requirements before conducting services. Subcontractors complete a Business Questionnaire (BQ) covering:

• Ownership information and disclosures
• NPI, TIN, and PTAN numbers
• Applicable licensure (DME/HME, Pharmacy, Oxygen, Respiratory Therapist, and other state-required licenses)
• Accreditation Certification
• Professional and General Liability insurance ($1M/$3M)
• EFT and W9 forms

Recredentialing

Every three years, subcontractors must recredential. You will receive notice 60 days in advance, with 30 days to submit your application. Failure to recredential on time may result in contract suspension or termination.

As licenses, accreditations, and insurance policies are renewed, submit updated documents to credentialing@synapsehealth.com immediately upon receipt.

Adverse Actions

All adverse actions against your organization — including license or accreditation status changes — must be reported to credentialing@synapsehealth.com promptly.

Compliance

Exclusion & Sanction Screening

Subcontractors must conduct monthly exclusion screenings for all personnel and contractors across federal, state, and debarment lists. Results must be documented with the date, employee name, and findings. If any personnel become excluded, report to Synapse Health’s Compliance Department within one business day.

Fraud, Waste & Abuse

Synapse Health is committed to working with all partners to prevent fraud, waste, and abuse. Key laws subcontractors must be aware of include the Anti-Kickback Statute, Beneficiary Inducement Statute, Stark Law, and the Federal False Claims Act.

HIPAA

As a Synapse subcontractor, you are required to comply with all HIPAA regulations, including the Privacy Rule, Security Rule, and Breach Notification Rule. If you identify or suspect a breach, contact the Compliance Hotline at 1.833.609.5224 or visit synapsehealth.ethicspoint.com immediately.

CMS DMEPOS Supplier Standards

All Synapse subcontractors must adhere to CMS DMEPOS Supplier Standards. If your Medicare enrollment, accreditation, or licensing is revoked or suspended, notify Synapse immediately at dmeprovidernetwork@synapsehealth.com.

Quality Assurance & Performance Improvement

QAPI Program

Synapse Health maintains a Quality Assurance and Performance Improvement (QAPI) Program and relies on subcontractor partnerships to deliver on its commitments. As a subcontractor, you support QAPI by:

• Maintaining Medicare DMEPOS Certification and/or accreditation (TJC or ACHC)
• Promptly reporting when an order cannot be filled or fulfilled on time
• Reporting equipment malfunctions, recalls, and adverse events
• Reporting possible fraud, waste, abuse, or HIPAA breaches
• Reporting possible patient abuse or neglect
• Assisting with investigations and promptly reporting changes in licensure, accreditation, or insurance

Product Safety & Adverse Event Reporting

Subcontractors must have a program to promote safe equipment use and minimize safety risks. All subcontractors are required to:

• Notify Synapse within 24 hours of any injury, incident, or adverse event resulting in patient harm
• Provide a written investigation summary and corrective action plan within 10 days
• Submit copies of any regulatory reports within 24 hours of submission or occurrence

Patient Complaints & Grievances

If your team receives a complaint or grievance from a Synapse patient, redirect them to contact Synapse Health directly.

Forms & Resources

All fillable forms, training tools, and updated resources are available on the DME Provider Resource Hub.