Insurance and Financial Assistance
Advanced Arm Dynamics has a national team of authorization specialists and case managers to facilitate insurance authorization and other types of funding assistance. We have a proven track record of successfully negotiating with reimbursement agencies to achieve quick authorization and funding. As the patient’s dedicated advocate, we work to obtain the maximum reimbursement possible and lessen the financial impact of prosthetic care. We can assist with prescription fulfillment, letters of medical justification, and appeals in the event authorization is denied. Below are some examples of how we help patients through the insurance approval and payment process.
A patient who was injured at work was having difficulty obtaining authorization from his insurance plan to receive the prosthesis that he needed. His employer had self-funded insurance, and because of this, would only cover the less expensive, body-powered hook prosthesis. However, the patient believed he needed a myoelectric prosthesis with a hand in order to be able to do the daily tasks associated with his job. Our team of authorization specialists worked for several months to help the employer understand the medical necessity and the patient’s need for the myoelectric prosthesis versus the body-powered prosthesis. The patient is now happily using a myoelectric prosthesis and is able to continue his occupation.
A patient with a congenital limb difference needed help with asking her insurance company to approve a replacement prosthesis. With our assistance, the insurance company was convinced the patient needed an aesthetically pleasing prosthesis for her occupation. The patient received the prosthesis she wanted and was very grateful to have support managing the challenges of her insurance company’s authorization process.
A Medicare patient needed a transhumeral (above-elbow) prosthesis. Our authorization team worked to educate Medicare about the patient’s specific needs and why a replacement prosthesis was medically necessary every three to four years for this patient. We were able to secure payment from Medicare and the patient has received his replacement prosthesis without interruption.
Funding options include:
Health Insurance Carriers
- Indemnity plans
Workers’ Compensation Carriers
- Workers’ compensation insurance carriers
- Self-funded employers
- Medical management companies
Liability Insurance Carriers
- General liability insurance
- Automobile insurance
- Homeowner’s insurance
- Vocational Rehabilitation
- Veterans Affairs
- For those patients who choose private payment, we develop a payment plan based on your individual needs