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David McGill Blogger

Upper Extremity Reimbursement Support

Posted by David McGill | September 06, 2017

Special Guest Post: John Grabill (Touch Bionics)

In 2016, Össur acquired Touch Bionics, a manufacturer of high-quality upper extremity prostheses. As we work to integrate reimbursement resources here on Össur R&R, we wanted to share with you what services and tools we have for Touch Bionics products. Here's what you need to know:

  1. Prior Authorization – Touch Bionics has product checklists that include insurer-specific requirements to help ensure that you collect and include all the information needed to establish the medical necessity of the prescribed device.

  2. Templates – Touch Bionics also has exemplar letters of medical necessity. These templates attempt to provide specifically-targeted information concisely so that both payors and health care providers (prosthetist, physician, occupational therapist) can quickly and easily understand why the chosen prosthesis/es are clinically appropriate for a particular patient.

  3. Pre-Submission Review – Touch Bionics offers customers the opportunity to have its Reimbursement Specialists review their claim packets before submitting them to the payor. This educational service ensures that the claim includes accurate product information and references to appropriate clinical research. For more comprehensive review and assistance, Touch Bionics also offers a "pay-for" version of this service.

What does this mean for you?

Touch Bionics' experience working with customers over the last several years shows that collaborating to establish the strongest possible clinical evidence supporting medical necessity produces powerful, positive results. As you have read many times over the years on Össur R&R, doing the hard work up front pays huge dividends in the long run, whereas trying to shortcut the documentation process almost always leads to poor outcomes.

We recognize that this is not a typical R&R post. It doesn't summarize new claim review results from Medicare or analyze a proposed change to a particular policy, rule, or coverage determination. We thank you for allowing us to explain how Össur R&R's resources will increasingly include upper-extremity-specific information in the future, including downloads in Össur R&R's Reimbursement Resources section. We hope you find them useful.

For questions about Touch Bionics reimbursement support, please contact us at Reimbursement@touchbionics.com with any questions, or reach out directly to me, John Grabill, National Reimbursement Manager for Upper Extremity services at john.grabill@touchbionics.com or toll free at 855-694-5462 ext. 286. And if you are going Las Vegas to attend the AOPA National Assembly, please stop by and introduce yourself to us at Booth 533.

Össur R&R

The Source for O&P Reimbursement & Regulatory News & Analysis

If you have any questions for Össur’s Reimbursement Team or about Össur’s Reimbursement Services, please contact us at reimbursement411@ossur.com