HELPING YOU UNDERSTAND YOUR INSURANCE
Insurance companies have made it more difficult than ever for Medical Equipment Companies and their patients. They determine how much we can bill and if they will allow benefits.
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Listed below are the steps our friendly staff will help assist you with before we can submit your claim.
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Our staff will Verify your insurance eligibility - we will determine if you have coverage and how long it will last.
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Verify that you have Durable Medical Equipment Coverage - not all insurance offer DME coverage.
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Discuss your benefits including any deductibles, out of pocket expenses and co-insurances - Most insurance have a yearly deductible that must be met before they will pay for the item. Most insurance will only cover up to a certain percent, leaving the patient with a co-insurance. If your policy includes an out of pocket expense, your insurance usually will cover 100 percent once that is met.
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Request all medical documentation from your ordering physician - Each device requires that certain criteria be met. You must meet the qualifications for the specific item you need as required by your insurance. This includes office notes from your physician that document why they ordered the device, and the specific diagnosis.
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Obtain any prior approvals if required - This will include obtaining medical documentation and submitting to your insurance. Prior approvals may be granted the same day or could take up to 30 days.
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Claim submission - Once we receive all the required documentation, we can now submit your claim for payment.
Deductibles - If you have a yearly deductible, this must be satisfied before a benefit payment can be made. Our bills for services may be applied to your deductible.
Coinsurance - Once your deductible has been satisfied, your insurance will reimburse us their percentage of your coverage.