Billing & Intake Process – Prosthetic Devices
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Items Needed for the Intake Process
- Your prescription
- Your driver’s license
- Your insurance cards
It’s very important that you provide us with all of your insurance cards.
Even though a common thought is that some insurance cards might not be needed or that one insurance is going to pick up everything in full, however, that isn’t always the case since some insurances need prior authorization. If we don’t have all your insurance items, it can cause an issue in the payoff process and delay your service.
First Visit Expectations
On your first visit for the prosthetic, you want to make sure you have a clearly written prescription for the prosthetic. You must have seen your doctor for the need of the prosthetic written on your prescription within the last six months.
For example, if you go to your doctor for a cold, and while you’re there, you ask for a back brace, they did not see a need for the back brace. It has to be clearly written in your clinical notes that you need the back brace and why.
If you’re an existing patient and you’re needing a recurring item, and you have not been to your doctor, we can fax the prescription request to your doctor for you. However, we will not be able to give you the item until we get the prescription.
After the Intake Process
Once you go through the intake process and the intake staff has all your paperwork processed, they will send you back to the practitioner to be assessed.
- If it’s a custom prosthetic, they will cast you or take custom measurements.
- If it’s an off-the-shelf prosthetic, they will fit it on you. If we have it in stock, we will put it up with your name on it.
Your prosthetic will then go back to the authorization department who will check your insurance to see if it needs a prior authorization and see what paperwork we need from your doctor. They will then contact your doctor’s office and get all paperwork needed.
This process can take some time because it’s dependent on your doctor and how quickly they get us what we need.
Some patients have patient portals with their doctors and are able to have access to their doctor’s clinic notes. If you can bring that in or get that to us it would help out a lot because a lot of the delay is trying to get clinic notes from the doctor.
We are currently unable to provide a timeframe on how long it can take to get your prosthetic because there are too many variables at play.
- Your insurance company and what paperwork is needed
- Your doctor and how long it takes to get that paperwork
- Supply shortages due to COVID
Some insurance companies will give autorization within 48 hours. Some insurance companies unfortunately take 7-14 days. Payment can be a lengthy process and we have to go by what the insurance company tells us.
Thank you for your patience during this process!