Insurance benefits can be complicated and confusing at times. Below are answers to some questions most often associated with the care of venous and lymphatic insufficiencies.
What does the deductible mean?
The deductible is the amount of money a patient must first pay out-of-pocket, before the actual insurance benefits kick in.
What is an out-of-pocket expense limitation?
This is the total amount paid by the patient. Once the Out of Pocket is met, the insurance company will pay for services at 100%.
What does it mean when a product requires pre-authorization?
Certain insurance policies require products to be pre-authorized based on certain criteria. Sometimes products require mandatory pre-authorization if they are over a certain price. Also, certain products require pre-authorization just based on the item. The pre-authorization process can take anywhere from 30-45 days, or sometimes less.
Do I need a prescription to order my compression products?
Insurance companies and our company both require a prescription; we will contact your referring physician directly to obtain one. In order for us to obtain the prescription, we will need to ask you some questions regarding your clinical history.
Do I need a prescription to order my compression products?
Insurance companies and our company both require a prescription; we will contact your referring physician directly to obtain one. In order for us to obtain the prescription, we will need to ask you some questions regarding your clinical history.
What is a benefit “cap-per-year” or yearly maximum?
Sometimes the patient’s insurance policy will carry a Durable Medical Equipment (DME) or Orthotics & Prosthetics dollar maximum for the year. Once the patient receives that dollar maximum DME products for the year, coverage will no longer be given for products that are deemed DME.