The answer is yes, but sometimes no. There are several types of insurance that offer coverage for either renting or purchasing rehab equipment. Health insurance, auto insurance and worker’s compensation insurance are the three major payers that we encounter on a daily basis. Nearly all of the rehab equipment we offer needs to be authorized in advance before we provide them to our patients. Also, Bluegrass Bracing needs to verify active coverage and make certain your insurance plan is in effect before we proceed with providing the equipment.
Upon receipt of your prescription, Bluegrass Bracing will check the benefits available to you from your insurance plan. Most rehab equipment requires pre-certification and we have a team of dedicated professionals to perform that process. In order to pre-certify the rehab equipment, we will need to send several documents to your insurance company to be reviewed either by a nurse or a medical director. These documents may include office notes, CT or MRI reports, surgery notes, prescriptions and Certificates or Letters of Medical Necessity. Once we have approval to provide you the rehab equipment, Bluegrass Bracing will explain to you your out-of-pocket costs. These costs are due to your particular insurance plan’s deductible or co-insurance amounts.
Rehab equipment is sometimes not covered for unusual reasons. Patients that move to Kentucky from other states sometimes do not have out-of-network benefits that include Bluegrass Bracing. Some patients have health insurance plans that simply do not offer DMEPOS (Durable Medical Equipment, Prosthetic and Orthotic Supplies) benefits. Finally, some insurance companies have defined criteria that must be met in order for the rehab equipment to be a covered benefit.
Bluegrass Bracing’s medical billing team has a wealth of knowledge and experience in helping patients understand their insurance coverage. If you have a question at any time about what benefits are available to you and what your out-of-pocket costs are going to be, then please do not hesitate to contact our team for a complete explanation.