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Coverage Information
Your physician has prescribed bone growth therapy, commonly known as bone growth stimulation, to improve your opportunity for a successful fusion. Bone growth therapy is a safe, non-surgical treatment that uses a Pulsed Electromagnetic Field (PEMF) to activate the body’s natural healing process that may be impaired. You have the assurance of knowing that the Bone Growth Therapy devices are FDA approved and widely accepted by health care professionals. However, insurance coverage is complex and can vary widely with individual policies. For patients whose insurance provider may not fully cover these devices or for patients without insurance, this article describes BoneStim.com billing practices, which are based on insurance and government requirements.
What happens after my physician prescribes the device?
After your physician determines that you would benefit from bone growth therapy, he or she provides a written prescription and other information required by your insurance provider to determine whether the device is covered under your plan. BoneStim.com then works with your insurer to determine coverage before you receive the device. This process can take a few days or even several weeks.
What is “Medical Necessity?”
Health insurers, including Medicare, typically cover only those items and services which are determined by their policy to be “reasonable and necessary” for treating specific medical conditions. To determine medical necessity, health insurers require providers such as BoneStim.com to provide information about your diagnosis to determine whether the device is covered by your insurance plan.
Will my insurance company pay for the device?
Insurance policies are different depending on the plan you have chosen. If guidelines are met, the bone growth therapy device is accepted and approved by the majority of private and public health plans, including Medicare.
Does BoneStim.com pre-authorize the bone growth therapy device with my insurance company?
In accordance with the patient’s benefit plan, We will assist you in determining coverage by your health plan before you receive the device.
Is there financial responsibility for patients?
Even if an item is considered medically necessary and, therefore, covered by insurance, some health insurers require you to pay a portion of the cost. These costs could include a deductible, co-payment or other coinsurance amount. For Medicare patients, the coinsurance amount for a bone growth therapy device is generally 20% of the Medicare allowable amount. For patients with other health insurance, the coinsurance amount varies by insurer.
Can I pay my patient responsibility (coinsurance/deductible) online?
Yes. If your insurance has determined that you have a coinsurance/deductible, you will receive a bill with instructions for payment. Please visit BoneStim.com or contact a Patient Services Representative at # for additional details.
For Medicare patients, what is an “ABN?”
An ABN is an Advance Beneficiary Notice of Noncoverage for Medicare patients. This document gives patients advance notice that Medicare may not pay for the item prescribed by the physician for their condition. The ABN informs you of your financial responsibility if you choose to receive the device. If an ABN is required for your specific situation, you will be asked to sign it before you receive the bone growth therapy device.
What if I don’t have insurance?
Please contact our Patient Service Representatives at # to discuss payment options.
Who do I call if I have any questions?
BoneStim Patient Service Representatives are trained to answer your questions. For more information, please fill out this contact form or you can directly call this phone number (888) 616-4156