The ReBuilder and
Insurance
 
BEFORE YOU
ORDER...
Please
know, as
of this year The ReBuilder is now only
available for purchase with
a PRESCRIPTION.
Even if you
cannot (or do not want to) file an insurance
claim, a Rx is still required before product
would ship out. Please read the
PDF file below and contact us with ANY
questions. If you don’t have a primary
physician to call, we may be able to locate
one near you who is familiar with the ReBuilder. This product is worth the effort.
See/print this
PDF file for details on coverage.
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Most Private Health Insurance Companies Cover
the ReBuilder.
ReBuilder
treatments in a clinic and
product
re-imbursement for home use are routinely
covered by most insurance companies under the codes used for electrical stimulation.
ReBuilder is
Registered with the FDA
for the following uses:
-
Symptomatic Relief for Chronic
Intractable Pain
-
Post-Traumatic & Post-Surgical
Pain Relief
-
Increasing Local Blood
Circulation
-
Muscle Reeducation
-
Relaxation of Muscle Spasms
-
Prevention or Retardation of
Disuse Atrophy
-
Immediate Post-Surgical
Stimulation of Calf Muscles to Prevent Venous
Thrombosis
-
Maintaining or Increasing Range
of Motion
The ReBuilder
qualifies for reimbursement under the "DME
Billing Code" E0720.
The ReBuilder is
fully registered with the FDA as both a TENS
device (DME Code E0720) (for pain) and
separately, as an EMS (DME Code E0745) for
muscle atrophy with intact nerve. Most
insurance companies recognize, understand, and
prefer the TENS description.
* DME = Durable medical Equipment
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Although the FDA
groups the ReBuilder with normal TENS devices
(because of their limited number of
classifications) the function of the ReBuilder is
exactly the opposite
of a common TENS device.
Basic TENS
is meant to close nerve channels to
block pain, while
the ReBuilder is designed to open nerve
channels, creating a reversal of
symptoms. |
Unfortunately, Medicare is
currently unavailable for coverage.
Model 300 has been partially covered in the
past, however new Medicare regulations have
restricted access to this wonderful product.
We do
not bill your healthcare provider. You file
a claim for reimbursement. **
**
On rare occasion, your provider WILL
pay us up front for the device.
Contact your provider to inquire about this.
BOTH Models 2407 and 300 are routinely covered.
You do NOT
need a prescription to purchase a ReBuilder,
but
you will need a prescription to provide to
your insurance company as part of your
claim to get it covered.
Most insurance
companies will
reimburse you
according
to the terms of your policy, usually 80-90%
of the purchase price.
Secondary coverage may pick up the rest.
Contact your provider if
you are unsure if it is covered.
In order to know exactly IF and HOW MUCH
will be covered, please contact your
healthcare provider and ask "what
is my coverage for
a TENS device for my chronic pain?
The DME Code is E0730". If they ask, "Is it a tens
device?", you can say yes to confirm that
they are looking at the correct code.
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The format
and codes your physician will need
are as follows.
Prescription Language
Should Include:
1) Diagnosis and (Code):
"chronic intractable pain" DX Code:
338.4 (ICD-10-CM Diagnosis Code
G89.4)
Other Possible Diagnosis
Codes: “Other Chronic
Pain”: DX Code: 338.29 (ICD-10-CM
Diagnosis Code G89.29), “Unspecified
Idiopathic Peripheral Neuropathy”:
DX Code 356.9 (ICD-10-CM Diagnosis
Code G60.9 ]
2) DME Billing Codes:
ReBuilder Model 300 (DME Code E0720)
for treatment of chronic pain.
ReBuilder Model 2407 (DME Code
E0730) for treatment of chronic
pain.
DME Billing Code E0731
Conductive garment (gloves
and/or socks)
Description is: "TENS or NMES with
conductive fibers separated from
patient's skin by layers of fabric".
And/or... "Area to be treated is too
large for the normal electrodes."
And/or... "Patient cannot tolerate
the adhesives of normal conductive
electrodes."
3)
FDA
Description: "TENS, ReBuilder, brand specific,
for pain."
(no
generic substitutions)
4) Medical Necessity:
"This device is medically necessary
for the treatment of intractable
pain unresponsive to drugs, surgery,
and/or physical therapy.
Optional Paperwork.
Can strengthen claim.
History of
Failed meds: To further
strengthen your claim, we suggest
your doctor also include a brief
history of failed medications or
other attempted modalities. (This
can be part of the "medical
necessity" statement.)
Evaluation
Study :
To further strengthen your
claim, we suggest your doctor also
include a brief evaluation study
showing improvement.
sample
click here for a printable version
of this |
This is the fasted way to get
reimbursed...
- 1. Confirm coverage with your
provider.
-
- 2. Talk to your doctor about
the ReBuilder and ask if he/she will
write the prescription.
- (If not, find a new physician
that has your best interests in mind!)
-
- 3. Purchase the ReBuilder and
then make a copy of your sales receipt
to include with your claim.
-
- 4.
Gather the sales receipt, the
prescription, and any other supporting
documentation, and then submit your
claim.
5. Reimbursement is sent
to you by your health insurance provider.
** The need for a "trial use"
and a 30-60 day re-evaluation is required for
some Insurance Plans. Some plans will not pay
until improvement benefit is documented by your
physician. This is why many people use the
ReBuilder for 30 days and then share results
with their physician, then file the claim. This
significantly strengthens your claim .
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The ReBuilder
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