Our Patient Accounts Representatives will be glad to discuss your insurance coverage and what services will or will not be covered. They will also obtain a Certificate of Medical Necessity from your physician for you. Please call our toll-free number 800-662-7993 and ask for a Patient Accounts Representative.
In most cases, our services are covered by Medicare and supplementary insurance. However, special rules may apply.
Before a device can be delivered, a Certificate of Medical Necessity must be completed by the referring physician. This policy is required by law and adhered to by our staff. We will acquire all necessary documents (eg, prescription, letter of necessity) required by Medicare.
Patients are charged according to Medicare’s maximum allowable charge (MMAC) fee schedule for all NJ healthcare providers. Medicare pays 80% of the MMAC, and the patient or supplementary carrier is expected to pay the 20% coinsurance and any outstanding part of the deductible.
Private Insurers (PPO, POS)
Prosthetic and orthotic services are covered under most health insurance policies. As with Medicare, a prescription and/or a Certificate of Medical Necessity from your physician is necessary. As a courtesy, we will file your insurance claims for you, acquire all necessary documentation, and/or apply for prior approval.
General Insurance Questions
If prior approval is obtained from your insurance company, we generally accept assignment on your claims. If after research no coverage is available we will do our best to acquire funding for you through a variety of programs. Our administrative staff is as good as our technical staff. If we get authorization from your carrier and they don't pay neither do you.
HMOs and Other Managed Care
At no charge, we will attempt to acquire insurance reimbursement for you. In many cases, negotiations with the carriers are successful. However, we must be provided with all of your insurance information in order to pursue reimbursement for you.
We accept NY and NJ Medicaid.