The Ortho Remedy

Prosthetic Center of Excellence

 

Insurance

Our Patient Accounts Representatives will be glad to discuss your insurance coverage and what services and/or prosthetics 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.

Medicare

In most cases, our services are covered by Medicare and supplementary insurance. However, special rules may apply.

Before a prosthetic 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. Our administrative staff is as good as our technical 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. If your insurance carrier is not listed below, pease contact our insurance experts

Insurance Carriers that are in network with The Ortho Remedy

  • Aetna NY/NJ
  • Agewell of NY
  • Affinity
  • Amerigroup
  • Amerihealth
  • Americhoice
  • Anthem BCBS
  • ArchCare
  • Centerlight
  • Cigna
  • Easy Choice/Atlantis
  • Empire BCBS
  • Evolutions Healthcare Systems
  • Fidelis Car NY
  • GHI
  • Guildnet
  • Hamaspik
  • HealthCare Partners
  • Healthfirst NY
  • Horizon Blue Cross Blue Shield
  • Horizon NJ Health
  • HIP
  • Independence Care Systems
  • Island Group Administrations
  • Magnacare
  • Montefiore
  • Multiplan
  • PHCS
  • Qualcare
  • Tech Health
  • Touchstone
  • USA Managment
  • Village Care Max

 

 

Financial Assitance and Charitable Resources

If prior approval is obtained from your insurance company, we generally accept assignment on your claims. If after research no coverage is available, there are a variety of charitable organizations and financial assistance programs that may be able to help. If you are in need of financial assistance, we suggest looking into these options extensivley, and educating yourself before any appointment is made. Click the link below to explore the possibilities and learn what you need to request financing for a new prosthesis.

Financial Assistance

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.

Medicaid

We accept NY and NJ Medicaid.