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Prescription Requirements and Patient Forms

Bluegrass Bracing provides bracing and rehab equipment services for patients as directed by their physician. We only treat patients that have an original signed prescription from their physician. In some instances the patient’s physician may send the prescription directly to Bluegrass Bracing and ask us to fit the patient at home or in our clinic after the services have been approved by the patient’s insurance. Other times the patient’s physician may call Bluegrass Bracing with an initial “verbal” order to fit the patient in a hospital, rehab center or nursing home. Bluegrass Bracing will then follow-up with your physician in order to obtain an original signed prescription that substantiates the initial “verbal” order.

The process to authorize bracing and rehab equipment services for patients is very involved. Bluegrass Bracing will work with you and your physician in order to get all documents needed to secure approval through the pre-certification process. Most of our physician referral sources keep Bluegrass Bracing script pads in their office. On the back of a Bluegrass Bracing prescription is a map to our office. Please call or visit our office to schedule an appointment and to begin the insurance pre-certification process. All patients must fill out a Patient Information Sheet, so we have your current demographic information. We also recommend that all patients fill out a Patient Questionnaire in order for our practitioners to know more about your medical history. You can click the buttons below to download any of our patient forms.

PATIENT INFORMATION SHEET – BRACING

PATIENT INFORMATION SHEET – GAME READY

PATIENT INFORMATION SHEET – CPM

PATIENT INFORMATION SHEET – BONE STIM

PATIENT QUESTIONNAIRE

PATIENT SATISFACTION SURVEY

BLUEGRASS BRACING’S PRIVACY NOTICE

PATIENT BILL OF RIGHTS

MEDICARE SUPPLIER STANDARDS

ADVANCE BENEFICIARY NOTICE OF NONCOVERAGE