Coverage Clues
Insurance coverage for members of the military who are treated at an MTF
Tricare
The app that outlines payer guidelines
Power Apps/EXOGEN Guidelines app
Type of bone where the length exceeds the width and where the two ends are typically wider than the shaft
Long bone
The group who will make contact with the patient regarding their insurance benefits
Patient Financial Services
The two indicated acute fracture sites
Distal radius and tibial diaphysis
This type of facility treats patients who do not typically qualify for Tricare but did serve in our military
Veterans Affairs Medical Center
The reports you receive with order and territory information for that period
Cup of Joe reports
Fill in the blank: Some commercial payers will cover ______ fractures with a _____________that can negatively impact a patient's healing
acute, comorbidities
The time in which a Medicare patient can get unlimited treatments on their device
5 years
The listed contraindications for Exogen
None
This type of coverage is for patients who are 65+ but pay a premium for a private insurance plan to manage medical claims
Medicare Part C/Medicare Advantage
This is the guideline interpretation option you would choose if you do not intend to obtain additional documentation prior to submitting for pre-auth
Submit as is/Review as is
The type of nonunion that demonstrates the ability to heal but doesn't actually bridge the fracture gap
Hypertrophic
The amount a patient will owe if total OOP for the year has been met and order is denied
$0 or $525 (TM to choose)
EXOGEN has been reported as effective as an adjunctive non-invasive treatment of established nonunions in patients with ______________. Name two.
Internal or external fixation, undergoing treatment for infection, diminished bone quality.
This document should signed by an attorney and will serve as a promise of payment following a settlement from a motor vehicle accident or personal injury case
Letter of Protection
The name of the website used to obtain benefit eligibility
Proper name for heel bone
Calcaneus
This is a document that a patient can provide that will assist RS in processing an order with a closed Auto claim
An exhaustion letter
The patient adherence rate for Exogen
91%
After an adjuster approves a Worker's Comp order, the order will typically go to this type of vendor that offers employers volume discounts on medical products
Cost Containment Company
A Sharepoint site with updated resources, videos and guides for EXOGEN Sales teams
RT EXOGEN Connection
This is a fracture that occurs around an orthopedic implant, commonly following joint replacement surgeries
Periprosthetic Fracture
A patient's financial responsibilty if an order is approved that had originally been closed at-risk
Deductible and coinsurance (or estimated OOP)
The percent of time that patients must use the device to qualify for the EXOGEN Rewards program
95%