After the patient talks with a prosthetist about their condition, goals, and health, a rough estimate can be prepared. A more exact estimate requires an evaluation appointment.

Cost

Prosthetic care is expensive and every person is concerned about the cost.
Oftentimes it’s difficult to tell someone how much their prosthesis is going to cost without an in-person evaluation. After the patient talks with a prosthetist about their condition, goals, and health, a rough estimate can be prepared. A more exact estimate requires an evaluation appointment.

If you need help with payment options or resources, please ask us. Our patient financial advocates will assist you in finding help. We have a list of resources we can use to help you get the prosthesis you need.

Insurance and Patient Financial Obligation

Understanding and completing the requirements and paperwork for private insurance, workers’ compensation, vocational rehab, disability, or Medicare can be confusing. Our patient financial advocates provide individual assistance as patients work their way through the process of securing financing whether it is private insurance, Medicare, or another source. They spend time understanding each specific situation. Each advocate is knowledgeable in the field of prosthetics, and they communicate with all pay-sources. They assist with phone calls, forms and mailings, and keep the patients and the prosthetists updated on the insurance process. With many years of experience in securing payment for prosthetic care, they are thorough and efficient. We believe providing this type of assistance to our patients is an important part of customized care.

We are in network for many insurance providers and work with many others on an out-of-network basis. To find out if we work with your insurance company, contact our office and a member of our administrative staff will be happy to help.

If the patient doesn’t have insurance, our advocates will help to find alternative funding options.

Understanding Changes in Healthcare

Medicare now requires more justification in documentation to cover prosthetic care. Since Medicare sets the standard for many private insurance companies as well, several of these requirements may also be necessary for private insurances. These standards include that a patient must see their physician prior to starting a new prosthesis and obtain the dictation notes from that office visit. Also, an initial prescription will be required to begin the prosthetic process, and will be followed up by additional documentation before the prosthesis can be delivered. Our patient financial advocates will manage what is necessary from your doctor in order to deliver your prosthesis. However, it is helpful for you, the patient, to be aware of what is required because this can extend the time it takes to obtain approval and to build your prosthesis.