Mobi-C® PAR (Patient Advocacy Resource) - Mobi
Transcription
Mobi-C® PAR (Patient Advocacy Resource) - Mobi
Mobi-C® PAR (Patient Advocacy Resource) Helping patients gain access to Mobi-C Total Disc Replacement The Mobi-C Cervical Disc is an FDA-approved technology designed to relieve neck and arm pain associated with degenerative disc disease or symptomatic cervical disc disease, while allowing the potential for motion in the spine. If your surgeon has identified you as a candidate for a one- or two-level Mobi-C and you would like to learn more about insurance coverage for this procedure, please consult your Mobi-C Patient Advocacy Resource, or PAR. CALL 502-231-6868 REIMBURSEMENT ® Introduction to LDR’s Mobi-C Patient Advocacy Resource (PAR) As a potential candidate for cervical disc replacement, LDR Spine is pleased to be able to introduce you to a reimbursement support service. This support service, the Mobi-C Patient Advocacy Resource (PAR), is intended to help you receive coverage in the event your insurer is not currently covering Mobi-C for one or two levels. Newer technologies like the Mobi-C artificial cervical disc can present challenges for obtaining reimbursement until coverage is established by all of the commercial insurers. One of the most effective ways of establishing coverage for you is appealing a denial through an external independent review. LDR intends to support you through this process with your insurer. All we need to get started is a signed authorization to proceed. We will contact your insurer on your behalf for a predetermination of coverage, we will appeal it if it is denied, and we will keep you and your surgeon informed throughout the entire process. It is important to know that this process takes on average three to four months to complete. We will do everything in our power to make this time as short as possible, and you are free to opt out of this process at any point along the way. This resource is available to you from Monday-Friday, 9am-7pm EST and can be reached as follows: • Phone: 502-231-6868 • Fax: 502-231-4996 • Email: CynthiaR@par-line.com How will the Mobi-C PAR help me with my insurance company? The Mobi-C PAR is a reimbursement support service that works on your behalf. The PAR will work together with your surgeon, the surgeon’s office, and your insurance provider. If your insurance does not cover this procedure to date, the PAR will help you by: Requesting a prior authorization of coverage from your insurance provider The PAR will contact your insurance provider to request a prior authorization of coverage for your procedure. This will likely be denied, but getting a written denial triggers your right to have your case reviewed by an expert. Initiating an appeal(s) If your prior authorization is denied, the PAR will coordinate the necessary appeals with your insurance provider to pursue an overturn of the denied coverage. Facilitating an external review If coverage is still denied after the insurance company reviews your claim internally, the PAR will then facilitate an external review with an independent reviewer. Why should I use the Mobi-C PAR service? • The PAR’s proven approach is resulting in more overturned denials, faster case-by-case approvals, and more universal policy changes to cover the procedure for all insured patients. • With each individual case that is submitted and overturned, patients like you come one step closer to gaining universal access to this technology from your insurance provider. What is my responsibility as a patient? • Call the Mobi-C PAR: 502-231-6868 • • • Monday – Friday 9am – 7pm EST During non-business hours, you may leave a detailed voicemail. Calls will be returned within one business day. Coordinate with your surgeon and the PAR to complete the required documentation. Expect that this process could take 3-4 months on average, but know that the PAR will do everything it can to expedite the process. Keep in touch with the PAR, as they will with you! Together, with patients like you, we will gain universal access to cervical discs from insurance providers! REF: MB RS 19 REV A 08.2015 ® United States 13785 Research Boulevard Suite 200 Austin, Texas 78750 512.344.3333 France Hôtel de bureau 1 4, rue Gustave Eiffel 10 430 Rosières Près Troyes, FRANCE +33 (0)3 25 82 32 63 www.ldr.com www.cervicaldisc.com www.ldrcoding.com China Unit 06, Level 16, Building A, Beijing Global Trade Center #36 North Third Ring Road East, Dongcheng District, Beijing, China, 100013 +86 10 58256655 Brazil Av. Pereira Barreto, 1395-19º Floor Room 192 to 196 Torre Sul-Bairro Paraíso Santo André / São Paulo-Brazil CEP 09190-610 +55 11 4332 7755 ©2015 LDR Holding Corporation and its Affiliates, All Rights Reserved LDR, LDR Spine, LDR Médical, a passion for innovation, Avenue, BF+, BF+(Ph), Bi-Pack, C-Plate, Easyspine, InterBRIDGE, Laminotome, L90, MC+, Mobi, Mobi-C, Mobi-L, Mobidisc, ROI, ROI-A, ROI-C, ROI-MC+, ROI-T, SpineTune and VerteBRIDGE are trademarks or registered trademarks of LDR Holding Corporation or its affiliates in France, the United States, and other countries.