Medicare welcome
Commercial plans supported
Medicaid — select states
90-day refills
Medicare & Advantage
We help patients meet criteria and handle documentation.
Commercial plans
PPO/HMO employer plans—requirements vary by plan.
Medicaid
Available in select states; we verify benefits for you.
Dual-eligible
We coordinate across primary & secondary coverage.
We work with a wide range of health plans, including Medicare and many commercial and Medicaid plans. Coverage varies by plan and state—use our fast eligibility check and we’ll confirm benefits and next steps.
We confirm plan details and do the legwork—no guessing. Here’s what members can expect:
Verify benefits
We check eligibility and any plan-specific criteria.
Gather documentation
We coordinate chart notes and prescriptions with your clinician.
Handle authorizations
When a prior auth is needed, we submit and track it.
Deliver supplies
We ship 90-day supplies directly to your door.
Exact rules vary by plan and state. We’ll tell you what’s required for your situation before anything moves.
This is a general overview, not an exhaustive list. Final coverage is determined by your plan. We confirm eligibility and any out-of-pocket costs prior to shipment.
No surprises
We communicate any estimated patient costs before shipment.
Clean claims
Electronic claims and plan-specific billing rules reduce delays.
Real people
Questions about deductible or copay? Our team will walk you through it.
Our onboarding is straightforward and designed to launch quickly while meeting quality and compliance standards.
Intro & alignment
Discuss coverage goals, member experience, and clinical criteria.
Credentialing
Exchange documents (W-9, NPI, BOC accreditation, policies) and complete supplier setup.
Workflow design
Confirm SWO, chart note requirements, and PA triggers to reduce friction.
EDI & billing
Configure electronic claims, modifiers, and remits per plan rules.
Pilot & QA
Start in select clinics: monitor turnaround, approval rates, and member satisfaction.
Launch & optimize
Roll out broadly with transparent reporting and refill adherence metrics.
Ready to offer CGM through Appy? We’ll set up a quick discovery call and share our quality & compliance packet.
If you’re a clinic asking your plan to add Appy as an in-network DME supplier, we can provide a one-pager and supporting docs.
HIPAA safeguards
Least-privilege access and audit trails for PHI.
Accredited DME
BOC-accredited operations and policies.
Data protection
Encryption in transit and at rest; secure document exchange.
Yes—Medicare beneficiaries are welcome. We’ll confirm eligibility and required documentation for CGM coverage.
We work with many employer-sponsored plans; coverage varies. Use the eligibility form and we’ll verify benefits for you.
Medicaid coverage differs by state. We support select state programs and can check your specific plan.
When prior authorization is required, Appy submits and tracks it. Supplies ship in convenient 90-day refills with renewal reminders.
Email outreach@appymedical.com to start onboarding. We’ll provide credentialing docs, map workflows, run a pilot, then launch with reporting.
