HomeGuides › How to order enteral nutrition

Ordering guide

How to order enteral nutrition with Scotts

What happens between the first call and the first delivery, what your prescriber has to document, and how resupply runs afterward. Written for patients and the people helping them.

Key takeaways

  • Three things have to line up: a need, a prescriber’s order, and documentation in your chart. We handle the third with your prescriber so you do not have to.
  • We verify coverage before anything is delivered and tell you what your plan says your share is.
  • Resupply runs on the policy’s schedule, tracked by us and confirmed with you before each shipment.

How it works, step by step

  1. Tell us what you need. Call (800) 304-7030, start in the order wizard, or have your clinician send a referral with the documents attached. If you already use a product, the manufacturer code on the box is the most useful thing you can give us: it settles size, style and fit without guesswork.
  2. We verify your benefits first. Medicare Part B, Florida Medicaid, Medicare Advantage and most commercial plans. Before anything ships you hear what the plan covers and what your share is, and if it is not covered we say so and quote a private-pay option instead.
  3. We collect the order and the documentation from your prescriber. For enteral nutrition that usually means:
    • A written order stating the formula, the daily volume or calories, and the route (pump, gravity, bolus)
    • Documentation of why oral intake is not sufficient — enteral coverage under Medicare is a prosthetic-device benefit and turns on documented impairment, not simply poor appetite
    • The tube type and size, and the date it was placed
    • For pediatric patients, weight and growth documentation
    You do not chase the paperwork; we do, and we tell you if something is missing.
  4. Delivery or shipping. Delivered and set up across South Florida, or shipped across Florida, with the instructions you need and a phone number for the questions that come later.
  5. Resupply, if it applies. Supplies that recur are tracked on the policy’s schedule. We check in before each shipment; nothing ships that you did not ask for. How automatic resupply works.

What Medicare looks for

Enteral nutrition (J-C only) is covered under Medicare policy LCD L38955, Enteral Nutrition. In plain words, the chart has to show this: Requires a permanent non-function or disease of the structures that normally permit food to reach the small bowel, OR a disease of the small bowel impairing absorption. The diagnoses it names include gastrostomy status, intestinal malabsorption, dysphagia, malignant neoplasm of oesophagus. Resupply under the policy is monthly, ongoing.

Policies change and plans differ; the link above is the current text. We do not publish allowances or quantity limits here because the number that applies to you depends on your plan and your chart. Ask us and we will tell you yours.

Products people order

The manufacturers’ own photographs, shown under our dealer agreements. Pick one to check coverage and order it; sizes and pack counts come next.

All nutrition product families

Brands we carry

Abbott Nutrition, Nestlé Health Science, Kendall, Covidien, Medline.

Questions people ask

Why is enteral nutrition treated as a prosthetic benefit?
Because Medicare covers it on the basis that the tube is replacing the function of a body part that no longer works — not as nutrition support in general. That is why the documentation has to describe a permanent or long-term impairment of the ability to take food by mouth. We will tell your prescriber what their note needs to say.
Can I get the formula my dietitian specified?
Yes — send us the exact product name. Substituting formula is a clinical decision, not a purchasing one, and we will not do it without the prescriber agreeing.
How much formula will I receive at a time?
Enough to cover the period plus a buffer, delivered on a schedule. Tell us if your rate changes and we will adjust before you run short.

Related

About this guide

This is general information written to be useful, not medical advice, and it is not a coverage determination. It does not replace what your own clinician has told you about your own situation — where the two differ, follow your clinician.

We deliberately publish no prices, allowables or fee-schedule figures. Those vary by plan, state and year, and a stale number is worse than none. Call (800) 304-7030 and we will verify your actual benefit.

Not sure where to start?

Call us and tell us what happened — a surgery, a new diagnosis, a discharge date, a supply you keep running out of. We will tell you what is usually needed, check your benefits, and ask your prescriber for the order if you do not have one yet.