Health Insurance Information
Insurance Coverage and Financial Responsibility
At Independence Prosthetics-Orthotics, Inc. we work with you to explain your insurance benefits and provide you with accurate information to help you understand your coverage and financial responsibility. An insurance verification form will be provided to help you outline your policy's coverage and limitations. Upon request, a service estimate can be provided to show the amount billed to your insurance company for your specific device.
Your specific insurance policy defines the terms of coverage for Durable Medical Equipment (DME). DME includes devices such as prosthetics (artificial limbs), orthotics (leg bracing), and medically prescribed shoes. We recommend that you become familiar with your individual insurance policy terms and limitations.
Your insurance policy defines the deductible, coinsurance, out-of-pocket costs, fee schedule, medical necessity, and authorization requirements. Based on a contracted fee, the cost for your item has been predetermined by your insurance company. All DME items are identified by a medical coding system called “L-Codes” or “A-Codes”. These codes describe the type of device you are receiving when we submit our bill to the insurance company. If you have secondary insurance, the coverage for that insurance plan can be determined as well.
Financial Responsibility Payment Policy
Our policy is to secure full payment at the time of the delivery if you have financial responsibility. For custom items, half of the financial responsibility is required before production of your item will begin.
We offer payment plans and/or CareCredit for patients who qualify. If you require a payment agreement or think you may qualify for CareCredit, please advise our front office administration and they will assist you.
At Independence Prosthetics-Orthotics, Inc. we recognize the complexity of understanding healthcare insurance. We will educate and advise you of your coverage options. As a healthcare business, our goal is to provide care for those with medical needs. To accomplish
**The payment agreement requires a 50% deposit with up to 3 months of automatically charged payments via debit card or credit card.
**To qualify for the CareCredit, you must complete the CareCredit application. If credit is determined, extended payment agreements and/or product discount may be offered upon review. If you have any questions, please call your prospective office.
Reasons you may have a financial responsibility:
YOU HAVE NO HEALTH INSURANCE: You will be responsible for the cost of our product and services.
YOU NEED NON-COVERED ITEMS: There are some items that are not covered by insurance (i.e. elastic items and shoe modifications). In these instances, we will require payment in full. At your request, we can still process billing through your insurance company and will reimburse you any difference if your insurance company pays.
YOU HAVE A COPAY: If you have not met your deductible and/or you have coinsurance and/or out-of-pocket costs. You are responsible for these expenses and our staff will advise you of your financial responsibility.
INSURANCE DENIALS: If the insurance denies coverage as “not medically necessary” or “experimental” Insurance companies may deny an item if you have had an item of the “same or similar” item within the past 3-5 years
If a denial does occur, you will be notified. Our billing staff will work to appeal any insurance denials on your behalf. This may require requesting medical information from your physicians and/or therapists.
Please Note: If you are a Medicare beneficiary receiving a non-covered item, you will be required to sign an Advanced Beneficiary Notice which states that you were advised that Medicare may not pay for your item.
- Most workers compensation and auto policies upon approval
- Most major medical insurances and third-party payers
Care Credit is a payment solution for your medical expenses. Click the logo below to learn more!
Please contact us at (302) 369-9476 to verify acceptance and coverage, if your insurance company is not listed below.
- Bankers Life and Casualty
- CIGNA Healthsprings
- Delaware Medical Insurance
- Health Options Plan
- Highmark Health Options
- Independence Blue Cross
- Keystone First
- Keystone HMO
- Pennsylvania Medicaid
- TriCare for Life
- United Healthcare
- United Healthcare Community Plan