The equipment usually arrives before anyone in the house has been shown how it works. A home oxygen order moves through the physician's office, the supplier, a delivery driver, a setup visit, a backup supply, and eventually a service call or a pickup. Each step creates a paper record, and that record decides who pays for the next step. Read the papers as they come, not at the end when a bill arrives.

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Before the Truck Comes: Check the Order and the Supplier

Start with the written order from the physician's office. Look for the name of the patient, the equipment it names, and the date the physician signed it. Then ask the supplier to confirm that it has the order on file and that it is enrolled with Medicare, or with Missouri Medicaid if Medicaid is involved. A supplier that cannot name the order it is filling is a reason to stop and call the physician's office before any delivery is booked.

Ask the supplier three questions before it sets a date: whether it bills Medicare directly, what your share is expected to be, and who to call about the equipment after hours. Write the answers on the order, with the name of the person who gave them. Check the rules against the federal and state pages listed on our Sources page, and take any question you cannot settle to a counselor before you sign anything else.

The Delivery Ticket Is the Equipment Record

When the driver arrives, match the equipment to the order before you sign. Write down the model, the serial number on the unit, the number and size of any backup cylinders, the length of the tubing, and the name of the person who signed. Note anything missing from the ticket, such as the carrying case, spare filters, or the written safety sheet. Photograph the label on the unit next to the ticket. If the ticket and the order disagree, do not sign the line that says the equipment was received as ordered until the supplier has answered in writing.

Keep the ticket with the order. Insurance and the supplier will both ask for it later, and a serial number that was never written down will slow every service call that follows.

The Setup Visit: What Gets Checked and What Gets Taught

The setup visit is the install step. Ask who will do it, whether it is the supplier's own technician or a contractor, and what the technician will check before leaving. A complete setup visit covers placement of the unit in a room with clear space around it, a test of the alarm and power switch, a tubing route that does not cross a walkway, and a walk through of the written instructions. Ask the technician to show you the alarm sound and the number to call if the unit stops. Have the family member who will be the first to respond watch the demonstration and repeat it back.

Placement is a safety question, and the supplier's safety sheet sets the distances from heat, open flame, and smoking. Do not rely on memory. Tape the sheet where the family looks first. The flow setting belongs to the physician's order and to the supplier's instructions. A family member, the physician, or the supplier changes it, and a hired or in-home non-medical caregiver does not. If the order and the setting ever disagree, the call goes to the physician and the supplier.

The Backup and the Power Plan

Ask the supplier what backup supply comes with the unit, how often it is refilled or replaced, and what to do during a power outage. Get the answer in writing, along with the phone number for an outage and the hours when that number is answered. Then ask your electric utility whether it keeps a registration for households that depend on powered medical equipment, and what it asks you to provide. Our Local Help page lists the places in St. Louis where you can ask that question by phone.

Service Visits and the Log

Ask the supplier for its service schedule in writing: how often a technician checks the unit, who calls to book the visit, and who pays for a repair that is not covered. Keep a log in a notebook beside the equipment. Record the date of each visit, the technician's name, the work done, any part changed, and the serial number of any replacement. A replaced part with no ticket is a gap in the record, and that gap will show up at the next claim or the next dispute.

Pickup and the End of the Rental

Medicare generally pays for home oxygen equipment as a rental, and the rental has a defined end. Ask the supplier when the rental period is expected to end, what happens to the unit at that point, and who arranges the pickup. Ask for the pickup ticket and file it with the order. If the supplier stops coming, or the physician changes the order, the paper trail is what lets the next supplier take over without starting from zero. Do not return the equipment or cancel a service call until you have confirmed the step with the supplier and the physician's office.

Where to Get Help Reading the Papers

If the paperwork is unclear, start with the free counseling and local aging resources on our Local Help With Paying for Care page. The Start Here page gives the order in which to read the rest of this series. Questions about whether a specific charge is covered belong with the supplier and the payer. Questions about whether oxygen is needed, or at what level, belong with the physician, and this article does not answer them.

The Oxygen Unit Arrives Before Anyone Explains It: Walk the Order, the Delivery Ticket, the Setup Visit, the Backup Plan, the Service Log, and the Pickup