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insurance justification for Glider?

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  • insurance justification for Glider?

    Does anyone have a link to a report or study that I can use to help justify to our insurance company that they should pay for the Glider option to an EasyStand Evolv?
    I recall the link a few weeks ago where someone mentioned that they had cut a deal with BlueCrossBlueShield, so that the individual paid for the Glider option while BCBS paid for the rest; I'll try to do that, but first I'd like to see if I can get BCBS to foot the entire bill.
    - Richard

  • #2
    If you have BCBS approving a frame, you are a big step in the right direction. Just make sure they dont pull the 'reasonable and customary' nonsense when it comes time to pay up. On my 5000 with mobile kit they initially said that $1200 was reasonable and customary. After about a month of me and Apria pestering them they slid the remainder of the money under Apria's door without admitting to the payment I guess for us to just go away. They were kind of playing hardball with me when battling this out, but the paper trail said they gave approval to the vendor (there was some question as to if this was in error or not it seems), so I guess in the convoluted world of insurance they had to pay up. Not that they didnt try hard not to. Total headache for sure, I'm not sure if I would do it again in retrospect.

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    • #3
      Sample LMN

      Richard,
      Have you seen the sample LMN for the glider on the easy stand website?
      It's at:
      http://www.easystand.com/PDFs/Sample...olv_Glider.pdf

      BCBS paid for my glider, and I believe my PT used the sample LMN as a guideline.

      Jeff
      Doh!

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      • #4
        Health Benefits & Funding

        EasyStand has lots of health benefits & funding info. LMN as mentioned above, research studies, articles, etc. They also have a Funding Guide in booklet form that they send out free of change all you have to do is request it.
        www.easystand.com

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        • #5
          I used a lot of EasyStand's info in a letter of justification, which our physiatrist sent to BCBS. But as I expected, they denied the Glider option and paid for the rest. The Evolv+Glider is in our house now, although we don't yet have a shoulder/chest harness that is usable for my wife (and so we haven't been billed for any $$ yet). Our local EasyStand rep is trying to get us something that works. This process sure has moved slowly.
          - Richard

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          • #6
            what is cpt procedure code for glider, easystand, standing frame?

            what is procedure code for estim bike, estim unit?

            thanks for help

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