26-1042 Route Covered DME and Home Respiratory Services Referrals to Apria
Date: 09/11/26
Support member access and help shared-risk PPGs avoid capitation payment deductions
Apria Healthcare® is Health Net's preferred contracted provider for covered durable medical equipment (DME) and home respiratory services.
Using Apria for covered DME and home respiratory services referrals helps streamline access to covered services and supports efficient referral processing.
Route covered DME and home respiratory services referrals to Apria to support timely member access to care and help shared-risk participating physician groups (PPGs) avoid capitation payment deductions.
What you need to do
- Review your referral workflows to ensure they route covered DME and home respiratory service referrals to Apria.
- Inform office staff and referral coordinators that covered DME and home respiratory service referrals must be directed to Apria.
- Register with ApriaLink to submit orders online.
Important information for shared-risk PPGs
When covered DME is Health Net risk or shared risk and is included in a Health Net capitation arrangement, referrals sent to Apria do not require authorization from Health Net or the PPG.
Referring covered DME to a supplier other than Apria may result in capitation payment deductions for shared-risk PPGs.
For additional information, refer to Health Net’s operations manuals at Provider Library > select line of business > Provider Manual > Benefits > Durable Medical Equipment. Also see Benefits > General Benefit Exclusions and Limitations.
How to submit referrals to Apria
1 Identify members who need DME or home respiratory services, such as oxygen therapy, enteral nutrition, continuous positive airway pressure (CPAP) therapy, negative pressure wound therapy or other covered DME.
2 Submit the referral request to Apria and retain documentation of the request.
- Fax: 888-492-0010
- Phone: 888-492-7742
3 If you do not receive a response within 24 hours, contact Apria's Central Intake and Admissions team at the phone number above. The hospital's onsite review nurse may also assist.
Examples of covered items available through Apria
Apria provides a broad range of covered DME, home respiratory services and medically necessary disposable supplies used with covered DME, including, but not limited to:
- Bandages
- Braces
- Breast pumps and supplies
- Canes
- Catheters
- CPAP devices and CPAP/BiPAP supplies
- Crutches
- Feeding tubes
- Nebulizers
- Negative pressure wound pumps
- Oxygen equipment
- Syringes (not pre-filled)
- Walkers
- Wheelchairs
- Whirlpool bath equipment
Need help? Contact us
If you have questions regarding the information contained in this update, contact the Health Net Provider Services Center by email, by phone or through the Health Net provider portal.
Provider Services
Line of business | Phone number | |
|---|---|---|
Ambetter from Health Net IFP Ambetter PPO | ||
Ambetter HMO | ||
Health Net Employer Group HMO, POS, & PPO | ||
Medicare (Individual & Employer Group) (Wellcare By Health Net) | ||
Medicare Supplement | ||
Behavioral Health providers | N/A |
This information applies to Physicians and Practitioners, Participating Physician Groups (PPGs), Hospitals, Ancillary Providers, and Behavioral Health Providers.