Billing & Intake Process – Orthotic & 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. Some insurances require 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 prosthesis or orthotic device, you want to make sure you have a clearly written prescription for the device. You must have a prescription from an appointment with your doctor that is within the last six months. The appointment must be specifically for the need of the device.
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.
Existing Patients
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 prosthesis or orthotic device, they will cast you or take custom measurements.
- If it’s an off-the-shelf device, they will fit it on you. If we have it in stock, we will put it up with your name on it.
Your device will then go back to the authorization department which will check your insurance to see if it needs 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 can help speed up the process. Most of the time we see the delay in trying to get clinic notes from the doctor.
Payments
We are currently unable to provide a timeframe on how long it can take to get your prosthesis or orthotic device 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-19
Some insurance companies will give authorization within 48 hours. Some insurance companies, unfortunately, take 7-14 days. Payment can be a lengthy process depending on your specific insurance company and the requirements they’ve set.
Thank you for your patience during this process!
