Will insurance pay for my iWALK crutch?
Answer – Maybe
The current insurance climate in the USA is very complex, and there is no easy answer to this valid question. It all depends on your insurance company and your specific policy. But we’ve tried to simplify things and give you a road map towards finding the answer and getting the maximum reimbursement possible. Submitting your own insurance claim isn’t as hard as you think. Read on.
We’ve distilled the process into three steps:
- Find out if it will be reimbursed and how much you can expect.
- Get a prescription from your physician
- File your insurance claim
Insurance claims are typically paid within 30 days as required by most states
Filing for Insurance Reimbursement on your crutch? Follow these steps for success!
Step 1 – Find out if your insurance will reimburse your iWALK crutch purchase
Contact your insurance carrier. Typically there’s a phone number, often toll free, on the back of your insurance ID card. Failing that, you should be able to find it on your insurance company’s website, or ask your human resources representative. Try to have your insurance ID card handy when you contact them – they will probably ask you for information printed on the card. Once you get in touch with your insurance company, request the following information:
- Are Crutches or Walkers a covered expense by your plan? (note, crutches walkers, etc. are also often referred to as “Durable Medical Equipment” or “DME” for short.
If the above answer is yes, then the IWalkfree will be eligible for either a partial or full reimbursement.
- Have you fulfilled your deductible requirements ? Note – even if iWALKFree is 100% reimbursed by your insurance, if you have not met you deductible (if any), you might not receive a reimbursement.
- Next, find out if there are any special forms need to be completed for you to file for reimbursement. If so, ask where you can get them (examples – download from their website website, have it faxed or mailed to you.
- Find out if you will need a physician’s prescription to get a reimbursement. This is almost always a requirement. Try to find out which physician is required; i.e, does it need to be your orthopedic surgeon? Your primary care physician? Your physical therapist? The more available to you, the better.
- Find out if there a time limit for filing for reimbursement.
- Find out if you must purchase the device “in network”, and, if so, get a listing of network providers. In network providers are retailers of medical equipment that have existing contracts with the insurance company.
- Request the mailing address as to where to mail your claim for reimbursement. Ideally, you can e-mail or fax the completed form instead.
- At this point, try to get a phone number for a person that you can call to assist you in filling out the form if you have questions.
Once the above information is obtained you now know where to file your claim, if a specific form is needed by your carrier, and how long you have to get the information in for reimbursement. You can now move to Step 2.
Contact your physician for a current prescription (if required by your insurance company). You need the prescription to contain the following information:
- Your personal information (name, date of birth, etc.)
- Equipment presecribed; (i.e. IWalkfree hands free crutch)
- Length of time you will need the equipment
- Clinical diagnosis
Once you’ve obtained your prescription, you can move on to step 3.
Gather all the information from the last three steps.
- Complete the Claim form that you got from your insurance company (note – if asked, the insurance code commonly used for iWALKFree is E0118).
- Prescription from your physician
- Invoice from IWALKFree. Note – sometimes insurance companies want the description of the iWALKFree on the invoice to be very specific for their internal purposes. If you need your invoice modified to suit these requirements, simply call us and we can modify your invoice and send it to you directly.
- If not utilizing a claim form from your carrier be certain to write your Insurance policy number, name, address , dob on a piece of paper and include attached to your receipt and prescription.
- Make a copy of all the above information prior to submitting. Make sure you keep the originals.
- Mail or otherwise submit copies as instructed by your insurance carrier.
After 15 days you may contact your insurance carrier to verify your claim was received. Most plans take 15-30 days to enter your claim for processing.
My insurance company rejected my claim. Now what?
Insurance companies often have very specific requirements as to how the device purchased is described on the invoice. While we have optimized our invoice formats to comply, the requirements vary considerably from one insurance company to another.. If your insurance company rejects your claim due to device description on your invoice, and you purchased your iWALKFree directly from us, then we can modify your invoice to comply. Here’s what you need to do:
- Find out EXACTLY what the insurance company needs to have on the invoice. Be very specific.
Call us at 905 238-7630 or e-mail the information to firstname.lastname@example.org and we will modify your invoice to be in compliance. In order to do this, we need to know:
- Your invoice number (from your original purchase through us). If you don’t know your invoice number we may be able to identify your transaction if you provide us with your name and approximate date of your purchase.
- The exact description your insurance company requires.
- An e-mail address where we can send the modified invoice.
If you purchased your iWALKFree from somewhere else, you should contact them with the same information.
My insurance company STILL won’t pay. How can I get them to play fair?
If you insurance company isn’t performing, you should tell them that you will be contacting your local Insurance Commissioner’s office with a complaint. If they remain uncooperative, make good on your promise and file a complaint .
The Insurance Commissioners are your elected officials that serve to protect the public interest and regulate the business of insurance. Below you will find a link to the National Association of Insurance Commissioners website. From there, you can easily find your local commissioner. To find yours, simply select the state in which you reside. The name of your commissioner and their contact information will be provided.
Here’s the link to the National Association of Insurance Commissioners: www.naic.org
What happens next?
Contact your local Commissioner’s office per the instructions on their website. An official from your Commissioner’s office will typically take your personal information, claim history and contact the insurance company to start their own investigation on your behalf. Be specific on dates, persons whom you have spoken to and any information that was given to you by the insurance company. The more information you can provide, the easier it is for the Insurance Commissioners’ office to help you.