With year end in sight, an increase in insurance claims submissions is likely. We would like to offer a few helpful tips when processing orthotic claim submissions.
1. Complete the insurance claim form indicating the patient name, description of product dispensed and dollar amount received from the patient. Ensure that if the claim is an “assignment of benefits” claim, the insurance form is filled out correctly and the patient has signed off as required.
2. Attach a prescription, with a valid diagnosis, from a practitioner licensed to prescribe orthotics (practitioners may be insurance plan specific).
3. Attach a completed bio-mechanical and gait analysis.
4. Include the clinic invoice stating the product has been dispensed and paid in full or is an assignment of benefits. The invoice should include all the information that was included on the insurance claim form above.
5. Include the proof of manufacture provided by OOLab as it indicates the materials and processes used to fabricate the devices.
6. Include the ‘Manufacturing Process’ provided by OOLab as it indicates the various casting methods, scanning and processing technology, and the team used in the manufacturing process.
If there is any doubt about the insurability of the claim, we recommend doing a predetermination with the insurance company before ordering products to help ensure that your patient’s claims are processed with ease.
Following the tips will ensure the smooth processing of the orthotic claims. Please keep in mind these tips do not guarantee that an orthotic claim submission will meet all insurance requirements.