Insurance and Staffing FAQQ: How often will insurance companies generally pay for orthotics?
A: There is no set answer for how often they will pay. You'll need to call them and verify the plan. Some are a flat dollar amount per year and others are paid per condition. Just check it out with the company using the verification sheet provided by Foot Levelers. Be sure to follow the questions exactly.
Q: We are taking a loss on Foot Levelers products with some insurance companies and would like your help. Do you have any contacts or can you offer us any guidance in submitting to insurance companies?
A: Some insurers take a very limited stand on coverage for stabilizers. Unfortunately, due to the agreement that you’ve signed and are bound by, as a participating provider you may be forced to accept that amount. Some insurers classify stabilizers in with heel lifts. We know this is not the case. The first suggestion is to consider whether this plan is reasonable for you. The second is to work with Foot Levelers to gather information and data that we can use to try to educate the companies to allow for reasonable limits. No orthotic company has more peer reviewed research to support use of stabilizers.
Q: I have a question concerning insurances and orthotics. In the office we bill electronically. I am wondering how to get a justification for orthotics letter to the insurance company I am billing, before they deny the claim. Most insurance companies have gone electronic, and no longer accept paper claims. I am kind of stuck.
A. If an insurance company says that they need a letter of medical necessity along with the claim, then you must print it out on a CMS-1500 form and submit with the letter. You can also bill the services electronically, then once a claim number has been assigned, appeal with the letter of medical necessity, if need be.
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