Have your insurance card in front of you and be prepared to supply them with the following information:
Your insurance company may ask you for Procedure/HCPCS codes.
Here is the list for a PRC SGD:
Here is the list for a Saltillo SGD:
Be sure to ask your insurance representative for in-network and out-of-network benefits.
The deductible and co-pay may be different if PRC is an in-network or out-of-network provider with the insurance company. If PRC is out-of-network, we may be able to negotiate a single case agreement with the insurance company for in-network benefits.
Payment for co-pay and/or deductible will need to be secured prior to shipping equipment.
Ask if a physician's referral is required.
Usually, your primary care physician will need to refer the client to PRC for the SGD.
With this information, the insurance company should be able to verify the policyholder's benefits as well as review any coverage criteria questions.
Once the proper documents are received by the Funding Department, we will work directly with the insurance company to begin the medical review process.
Please note: The Funding Department cannot submit a claim to your insurance company until payment is secured and the device is shipped. The date of service is when the client takes possession of the equipment.