Paying for COOLIEF*
We know that when considering any medical procedure, cost matters — so we want to arm you with information before you talk with a physician.
Insurance coverage and prior authorization
COOLIEF* may be covered by Medicare and by certain private payers. However, it is important that your doctor confirms with your health insurance provider to determine if your procedure is covered.
In many cases, a prior authorization is required but could be denied if there are issues with the paperwork. Be sure to discuss this step with your referring physician.
What if I'm denied coverage?
You have the right to appeal a health insurance company’s decision to deny a payment for your procedure. In certain cases an initial denial can be reversed, and there are steps you can take to appeal the decision.
Work with your doctor’s office.
Make sure they file the proper appeals and that the claim was processed properly. Many times a claim can be denied because the paperwork was not completed properly.
File an internal appeal.
If the claim is rejected, you can also file an internal appeal. This is when you ask your insurance company to do a full and fair review of its decision. Make sure you complete all forms required by the health insurer. The COOLIEF* team can assist you with this process. If your state has a Consumer Assistance Program, they can also help file on your behalf. Several internal appeals may be needed before you can move on to an external appeal.
File an external review.
If coverage is still denied, you have the right to an independent, third-party review of your case. If your state has a Consumer Assistance Program, they can help file on your behalf.
There are COOLIEF*-trained specialists all across the country. Interested in an appointment?
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