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The Rebuilder |
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The ReBuilder® |
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| The Rebuilder and Insurance | |||
The ReBuilder is fully registered with the FDA as both a TENS device (DME Code E0720) (for pain) and separately, as an EMS (DME Code E0745) for muscle atrophy with intact nerve. Most insurance companies recognize, understand, and prefer the TENS description.
You will not need a prescription to purchase your ReBuilder, but you will need a prescription to provide to your insurance company as part of your claim. * Note: We do not bill your healthcare provider. You file a claim for reimbursement. If your physician prescribes a ReBuilder for you, he will write a prescription and provide you with a Certificate of Medical Necessity, and most commercial insurance companies will reimburse you according to the terms of your policy, usually 60-90% of the purchase price. Secondary coverage may pick up the rest. Contact your provider, it you are unsure if it is covered. In order to know exactly IF and HOW MUCH will be covered, please contact your healthcare provider and ask what your coverage is for a pain control device with "DME Code E0720". (The cost is $1299) If they ask, "Is it a tens device?", you can say yes to confirm that they are looking at the correct code. Chances are, they will know about the Rebuilder already.
This is the fasted way to get reimbursed...
5. Reimbursement is sent to you by your health insurance provider. ** The need for a "trial use" and a 30-60 day re-evaluation is required for some Insurance Plans. Some plans will not pay until improvement benefit is documented by your physician. This is why many people use the Rebuilder for 30 days and then share results with their physician, then file the claim. This significantly strengthens your claim. (sample)
Medicare sets the maximum allowable price and covers about 80% of that amount once your annual deductible has been met. Then, if you have a secondary, back up insurance, that usually pays most of the balance, but varies by company, plan, and individual. Each supplemental plan is different, and each person's deductible balance may be different so it is difficult to say what your portion would be. As an average, most patients will be responsible for about $100-200 out of pocket that is due after Medicare and other insurance claims have been completed in about 30 days after receiving their ReBuilder. * Note: Our billing partner DOES bill Medicare directly. Medicare Requirements:
In general, this is what you can expect in order to use Medicare: 1. Confirm benefit coverage (confirm here before anything else). NOTE: if you already know what you need to know and want get going, you can go to step 3.)2. Contact your doctor to let him know that you want a ReBuilder, and confirm if an office visit is required. 3. Forward these 4 things to the DME Supplier:
4. Upon receipt of your Rebuilder, return Proof of Delivery documents to DME Supplier. 5. Begin using ReBuilder as instructions describe. 6. Make a “30 Day” appointment with your doctor for a re-evaluation 30 – 45 days after beginning to use the ReBuilder. (You can make this follow-up appointment during step 2, to ensure you have an appointment time available.) 7. Record use of ReBuilder in provided Treatment Record form. 8. See your doctor for the “30 Day” visit. 9. Obtain and send, or have the doctor’s office send, the completed "Certificate of Medical Necessity" letter to DME Supplier.
What the DME Supplier Will Do:
Once your unit is approved by Medicare, your monthly supplies are provided as needed. Conductive garments like socks and gloves will need a separate prescription for each re-order, but can be replaced when medically necessary. Other supplies like self adhesive pads and batteries will only require a phone call from you to us to send them right out under Medicare benefits.
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