Insurance Reimbursement

You may wonder if your  insurance will pay for the vitrectomy recovery equipment rental?  We have been in business since 1995 and have worked through this issue with most insurance companies.  Here is what we have found:

1) You are best off if you contact your specific insurance provider in advance.  We have found that  insurance coverage comes in all shapes and sizes, many will cover the use of the vitrectomy recovery equipment if you obtain a prior authorization or pre-certification.  Obtaining a note from your doctor on their letterhead or prescription pad will expedite this process.   

2) If you have Medicare Part B benefits for home medical equipment, the Vitrectomy Recovery equipment is NOT covered by Medicare.  Any claims will be denied whether submitted by your provider or by yourself.  Medicare doesn’t recognize this equipment as “medical equipment”, even with a physicians letter of medical necessity. If you have Medicare supplemental insurance, most do not cover if Medicare does not.

3) If you fail to obtain a pre-autorization from your insurance company you can still attempt to get coverage by submitting your paid bill from us directly to your insurance company. 

4) To keep our prices the lowest we do not provide any billing services.  Since 1995 we have tried many times and have found the best options are the ones described above initiated by the patient.

5) Other companies may claim that they will bill your insurance company, but the end result will be rejection in most cases and lost time on your part.  Please follow the above procedures to get any reimbursement due to you.

To obtain preauthorization from your insurance company you will need to supply the patient’s full name, D.O.B, Insured’s full name, Group Number and ID number from your insurance company, letter from your physician declaring medical necessity, and any other insurance referral information.  In most cases you will need a proof of purchase from VitrectomyRecovery.org to complete your reimbursement.