Elite Home Medical Supplies
706 W. Lumsden Rd. Brandon, Fl  33511 
1-800-229-9600
email

We are a member of :

• License by Florida Medicaid 
• Medicare Provider
• Florida Association of Medical Equipment Services
• The Home Care Providers Co-Op.
• Brandon Florida Chamber of Commerce

Shipping


International Shipping
Medicare
Prescriptions
Returns
Client Bill of Rights
Supplier Standards
Notice of Privacy Practices

We encourage you to ask about our reputation. Yahoo has given us their

award for customer satisfaction. The Top Service Star next to a store's name is a sign of superlative quality. It means that the store is participating in our Customer Rating Program, and that customers who have ordered from that store have given it the highest ratings.

Nearly all Yahoo! stores have good customer satisfaction ratings, but those with a star are the best of the best, with at least 95% positive ratings.

Elite has teamed up with Yahoo Shooping to provide you a safe and secure shopping experience. When you place your order it is done on a secure channel protecting your information and your privacy! The information we gather at the time you place your order will never be sold to a third party and is used for our informational needs only!

• Shipping is calculated automatically when you place your order. The amount will show up on your order form.
• Customers with a Florida billing or shipping address may be charged additional tax on some items.
• Orders received after 2PM EST. will be begin processing the next business day. Orders placed on Saturday or Sunday will be procesed on Monday
• Orders are typically processed and shipped the next business day.

If you must have your order by a certain date, please enter the date required in the comment box on your checkout form, or email us, or call us 1800-229-9600. If it is at all possible to get your order to you by the date you request we will do so. It may mean a change of shipping type or rate.

• Foreign shipping charges will be calculated manually.
• Our usual shipping method is USPS Express Mail. Smaller items may go "Global Priority".
• We cannot determine Duty/taxes which may or may not be imposed by the country shipped.  These charges will be the responsibility of the addressee.
• We will notify you by email of any additional foreign shipping charges 
• International "Express" Shipping for four wheel walkers (rollators) will be a minimum of $100.00 USD

Physicians orders or prescriptions are required for billing medicare or Insurance.

If you have Medicare and if you are interested in checking to see what items may be covered by Medicare please click here

If you would like us to submit a claim to your insurance company and click here to enter your insurance information.

Some items require a prescription before they can be sold. Other items can be sold without a prescription but require one if would like us to bill your insurance company or Medicare

We always need a prescription for:

• Nebulizer Kits
• Oxygen Cannulas
• Self and Coude' Catheters
• Some wound dressings
• Aero-Chambers
• Mic-Key feeding extensions
• Feeding Tubes
• BiPap
• CPaP
• Syringes require a prescription in some states. If we are not sure that your state does require a prescription, We will need one.
  

Everything you purchase from Elite Home Medical Supply is fully guaranteed. Look your order over, and if not completely satisfied, we will exchange or return the item for a full refund within 20 days of receipt of the order. We cannot accept returns of opened boxes or personal hygiene items. Special orders may be subject to a 25% restocking fee. For a return authorization number, or for information on manufacturer warrantees, or any questions you may have, please call us at: 1-800-229-9600

NO RETURNS WILL BE ACCEPTED WITHOUT THE RETURN AUTHORIZATION NUMBER ON THE OUTSIDE OF THE BOX

Reason for the return If possible a copy of the original order should be enclosed with the merchandise with the reason for the return written on it.

Check with us about Medicare Assignment on your supplies. 1-800-229-9600

STEP I: We send you the following forms to be completed and signed:

A. PATIENT INFORMATION for our files. Please complete and sign.

B. HEALTH INSURANCE CLAIM FORM to release medical information (if necessary) and to enable ELITE HOME MEDICAL SUPPLIES to bill your
insurance for your medical supplies. PLEASE SIGN AND DATE.

STEP 2: You or your doctor must supply your prescription. Any prescription or order must be SIGNED and DATED by your doctor and include the supplies needed.

STEP 3: We will contact you to discuss the supplies needed upon receipt of properly completed forms.

STEP 4: We will send you your supplies by UPS (or US mail if you prefer)

STEP 5: We will train you by telephone in proper use of your supplies and equipment. You can call any time for advice on using your equipment or supplies. If we can not help you we can direct you to the toll free telephone number of the customer service departments of the manufacturers.

STEP 6: We will bill your insurance (including Medicare, Champus, Florida Medicaid, co-insurance, etc.) for you. You are freed of the responsibility of filing your own claims. In most cases Medicare or your insurance will pay 80% of the allowable for your supplies (assuming that your deductible has been met). The remaining 20% will be billed to your co-insurance. If you have any questions or need any additional information, please call our office at 1-(800)229-9600

1. As an individual receiving home care services, let it be known and understood that you have the following rights:
2. To select those who provide your home care services.
3. To be provided with legitimate identification by any person or persons who enter your residence to provide home care services for you.
4. To receive the appropriate or prescribed service in a professional manner without discrimination relative to your age, race, sex, religion, ethnic origin, sexual preference or physical/mental handicap.
5. To be dealt with and treated with friendliness, courtesy and respect by each and every individual representing the company who provides treatment or services for you and be free from neglect or abuse, be it physical or mental.
6. To assist in the development and planning of your home care program so that it is designed to satisfy, as best as possible to your current needs.
7. To be provided with adequate information from which you can give your informed consent for the commencement of service, the continuation of service, the transfer of service to another home care provider, or the termination of service.
8. To express concerns or grievances or recommend modifications to your home care service without fear of discrimination or reprisal. The Medicare hotline number is 1-800-633-4227.
9. To request and receive complete and up-to-date information relative to your condition, treatment, alternative treatments and risks of treatment.
10. To receive treatment and services within the scope of your home care plan, promptly and professionally, while being fully informed as to company policies, procedures and charges.
11. To refuse treatment and services within the boundaries set by law, and to receive professional information relative to the ramifications or consequences that will or may result due to such refusal.
12. To request and receive the opportunity to examine or review your medical records.
    
    I have been given a copy of the Patient/Client Bill of Rights
    
    
    Patient’s Signature: _______________________________
    Date: _____/_____/_____
    
    
    Thank you for your interest in Elite Home Medical Supplies. If we can be of any further help, please contact us by email at sales@elitemedical.com or phone us at 800 229 9600 or write us at 706 W. Lumsden Road, Brandon, Florida 33511

CMS MEDICARE DMEPOS SUPPLIER STANDARDS

Elite Home Medical Supplies
706 W. Lumsden Road, Brandon, Fl. 33511 (813) 654-2415 (800) 229-9600

Note: This list is an abbreviated version of the application certification standards, that every Medicare DMEPOS supplier must meet in order to obtain and retain their billing privileges. These standards, in their entirety, are listed in 42 C.F.R. pt. 424, sec 424.57(c) and are effective on December 11, 2000.

1. A supplier must be in compliance with all applicable Federal and State licensure and regulatory requirements.
2. A supplier must provide complete and accurate information on the DMEPOS supplier application. Any changes to thisinformation must be reported to the National Supplier Clearinghouse within 30 days.
3. An authorized individual (one whose signature is binding) must sign the application for billing privileges.
4. A supplier must fill orders from its own inventory, or must contract with other companies for the purchase of items
necessary to fill the order. A supplier may not contract with any entity that is currently excluded from the edicare program, any State health care programs, or from any other Federal procurement or nonprocurement programs.
5. A supplier must advise beneficiaries that they may rent or purchase inexpensive or routinely purchased durable medical equipment, and of the purchase option for capped rental equipment.
6. A supplier must notify beneficiaries of warranty coverage and honor all warranties under applicable State law, and repair or replace free of charge Medicare covered items that are under warranty.
7. A supplier must maintain a physical facility on an appropriate site.
8. A supplier must permit CMS, or its agents to conduct on-site inspections to ascertain the supplier’s compliance with these standards. The supplier location must be accessible to beneficiaries during reasonable business hours, and must maintain a visible sign and posted hours of operation.
9. A supplier must maintain a primary business telephone listed under the name of the business in a local directory or a toll free number available through directory assistance. The exclusive use of a beeper, answering machine or cell phone is prohibited.
10. A supplier must have comprehensive liability insurance in the amount of at least $300,000 that covers both the supplier’s place of business and all customers and employees of the supplier. If the supplier manufactures its own items, this insurance must also cover product liability and completed operations.
11. A supplier must agree not to initiate telephone contact with beneficiaries, with a few exceptions allowed. This standard prohibits suppliers from calling beneficiaries in order to solicit new business.
12. A supplier is responsible for delivery and must instruct beneficiaries on use of Medicare covered items, and maintain proof of delivery.
13. A supplier must answer questions and respond to complaints of beneficiaries, and maintain documentation of such
contacts.
14. A supplier must maintain and replace at no charge or repair directly, or through a service contract with another company, Medicare-covered items it has rented to beneficiaries.
15. A supplier must accept returns of substandard (less than full quality for the particular item) or unsuitable items
(inappropriate for the beneficiary at the time it was fitted and rented or sold) from beneficiaries.
16. A supplier must disclose these supplier standards to each beneficiary to whom it supplies a Medicare-covered item.
17. A supplier must disclose to the government any person having ownership, financial, or control interest in the supplier.
18. A supplier must not convey or reassign a supplier number; i.e., the supplier may not sell or allow another entity to use its Medicare billing number.
19. A supplier must have a complaint resolution protocol established to address beneficiary complaints that relate to these standards. A record of these complaints must be maintained at the physical facility.
20. Complaint records must include: the name, address, telephone number and health insurance claim number of the
beneficiary, a summary of the complaint, and any actions taken to resolve it.
21. A supplier must agree to furnish CMS any information required by the Medicare statute and implementing regulations.
Palmetto GBA
National Supplier Clearinghouse
Post Office Box 100142 · Columbia, South Carolina · 29202-3142 · (866) 238-9652
A CMS Contracted Intermediary and Carrier

I have received a copy of this document for my records.

Signature___________________________________________ Date________________________