SO-CLEAN URGENT MEDICAL DEVICE FIELD CORRECTION

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785-749-4878 | 800-527-9596
1006 West 6th St., Lawrence, KS 66044 (corner of 6th and Maine)

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CPAP Refills

Home CPAP Refills

 

Request a Refill of your cpap/bIlevel supplies

 

Easily refill your CPAP/BiLevel supplies by filling out our convenient online refill order form.

By completing this form you accept our Privacy Policy.

 

  • Contact Information

  • When would you like to pick up your order?

  • Please allow 24 hours to process your order, or 2 days if order is placed on Sunday.

  • If your insurance has changed since the last time you received supplies, please contact our office.

  • For those with Medicare insurance:
    Medicare determines the frequency that you can receive certain items. Those time periods are shown below in parenthesis. Medicare requires an annual office visit with your physician or medical practitioner.  An indication of your use and benefit of PAP therapy must be documented in this visit and a copy of this document must be on file with our company.
  • Customers with commercial insurance plans:
    We can bill most insurance carriers and they typically will cover these items every 6 months. A representative from our office will determine what you are eligible for under your plan.
  • All insurance plans: You will be responsible for any deductible or co-pay before we can bill your insurance.

  • Additional Information

  • Additional Information
  • Please select the supplies that you would like to have refilled:

  • Please select the supplies that you would like to have refilled:
  • Please select the supplies that you would like to have refilled:
  • Other Concerns

  • Other Concerns:

 

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