Can I bill private health plans or other third party payors (non-Medicare/Medicaid) for stimulation products?
Yes, in many situations you may bill and obtain reimbursement from private health plans (and in some cases, workers’ compensation programs) for stimulation products. Please be advised, however, that some health plans may require that you be a credentialed participating Durable Medical Equipment (DME) supplier in the plan to bill for and collect reimbursement for these devices. Such plans conduct audits to verify the surgeon’s contract status and will deny payment (or recoup payments already made) for DME if the surgeon or surgeon group is not contracted as a network DME supplier. In addition, there are laws in certain states that govern surgeon “self-referrals.” If your state has such a law, it could affect your provision of, and billing for, our stimulation products. We recommend that you: (i) check with each health plan to identify the requirements, if any, which you need to meet in order to bill for and collect reimbursement for our stimulation products; and (ii) consult with your h
Related Questions
- Can I bill private health plans or other third party payors (non-Medicare/Medicaid) for stimulation products?
- What HCPCS codes should I use with health plans and other third party payors for the stimulation products?
- Haven’t Medicare/Medicaid been better at controlling costs than private health plans?
