Insurance
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Rosie, our Patient Accounts Representative will be glad to discuss your insurance coverage and what services will or
will not be covered. She 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 Rosie.
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Medicare
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 must pay the 20% coinsurance and any outstanding part of the deductible.
Private Insurers (PPO, POS)
Prosthetic and orthotic services are covered under most major medical 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 prior approval is obtained from your insurance company, we generally accept assignment on your claims. If not obtained, the patient becomes responsible for the charges incurred. In this case, payment in full is due at the time the device is delivered. If for some reason you cannot pay in full at the time of delivery, let our Patient Accounts Representative know, and we will work out a payment plan for 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.
Medicaid
We accept NY and NJ Medicaid.
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