News update

Jun 02, 2026

Medicare Update: Synapse Health to Take Over DME Order Management

Beginning Sept 01, 2026, Synapse Health will manage the ordering and fulfillment process for certain durable medical equipment, commonly known as DME, for select Medicare Advantage members.

Synapse Health will act as a single access point for members and prescribers, helping connect patients with a broad network of qualified DME suppliers. The goal of this change is to make the DME ordering process smoother for providers, suppliers, and members.

Plans and States Included in This Change

Individual HMO and PPO Plans

Synapse Health will manage DME orders for members in:

Connecticut
District of Columbia
Delaware
Maine
Massachusetts
New Hampshire
New Jersey
New York
Pennsylvania
Rhode Island

Chronic Special Needs Plans

For C-SNP members, Synapse Health will manage DME in:

Delaware
Maine
Massachusetts
New Hampshire
New York
Pennsylvania
Rhode Island

Dual Special Needs Plans

For D-SNP members, Synapse Health will manage DME in:

Connecticut
Georgia
Maine

Plans Not Included

This update does not apply to the following Medicare Advantage plans:

Institutional Special Needs Plans
Institutional Equivalent Special Needs Plans
Group retiree plans

Why This Change Is Being Made

The current DME ordering and fulfillment process can create challenges for providers, suppliers, and members. Based on feedback from both providers and members, this change is designed to improve the overall experience and create a more organized process for ordering and receiving DME.

What DME Prescribers Need to Know

Starting Sept 01, 2026, DME items managed by Synapse Health should be prescribed through the Synapse Health e-prescribing portal.

In the coming months, Synapse Health representatives will contact prescribers to answer questions, provide guidance, and offer training options. Providers will also be able to access self-help resources and schedule personalized training through Synapse Health.

For members who need ongoing DME services after Sept 01, 2026, Synapse Health will work with current DME providers to support continuity of care or help transition members to a new DME supplier when needed. Prescribers may be contacted if updated orders or documentation are required.

What DME Providers Need to Know

Most DME providers will need to join the Synapse Health network if they want to continue providing standard DME services to most UnitedHealthcare Medicare Advantage members.

Synapse Health will contact providers with more information about network participation. Providers may also reach out directly at JoinOurNetwork@synapsehealth.com.

DME Categories Managed by Synapse Health

Synapse Health will manage selected DME categories, including:

CPAP machines
Diabetic supplies
Enteral nutrition products
Home ambulatory equipment
Hospital beds
Insulin therapy
Mobility aids
Negative pressure wound therapy
Ostomy supplies
Oxygen
Respiratory equipment
Respiratory vests
Sleep-related equipment
Urological supplies
Ventilators
Standard wheelchairs
Wound care supplies

DME Categories Not Managed by Synapse Health

The following DME categories will not be managed by Synapse Health:

Bone growth stimulators
Cancer treatment equipment
Cardiac defibrillators
Complex rehab equipment
Optune devices
Oral devices
Orthotics
Parenteral nutrition
Vision and hearing items
Prosthetics
Motorized wheelchairs

Need Help?

Providers and members with questions can visit Synapse Health or call 888-336-9363 for assistance.

Services

Credentialing

Credentialing is the rigorous process of verifying a healthcare provider’s qualifications, including their education, training, licenses, and clinical experience. This service ensures that practitioners meet the high standards required by insurance networks and hospitals to provide care and receive reimbursement.

Billing & Collection

Billing and Collection service involves confirming a patient’s insurance coverage, active status, and specific benefits before their appointment. By identifying co-pays, deductibles, and required prior authorizations upfront, staff can prevent claim denials and help patients understand their financial responsibilities.

Eligibility Verification

Eligibility verification is the process of verifying a patient’s health insurance coverage and benefits to determine what services are covered and the level of coverage available. This process is essential for healthcare providers to ensure that they receive proper reimbursement for services rendered and that patients are not left with unexpected medical bills.

Revenue Cycle Management

RCM is the financial process that manages the entire lifecycle of a patient’s account, from the initial appointment scheduling to the final balance payment. It integrates eligibility, coding, billing, and collections into a single, cohesive workflow aimed at maximizing a practice's profitability.

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