Insurance Process

Administrative Support at Next Step

insurance-process-135The administrative staff at Next Step Bionics & Prosthetics, Inc. is prepared to assist with any billing inquiries and insurance-related issues. We educate amputees about their expenses and encourage patient involvement in the insurance aspects of prosthetic care. We are the biggest advocates for Next Step patients, and we are happy to help them on a daily basis.

If you ever have questions or concerns, please contact us for assistance and clarification.

Health Insurance Coverage for Prosthetics

With years of combined experience in the profession, our administrative professionals bring clarity to prosthetic insurance benefits. We follow the internal flow of every patient transaction and offer courtesy benefit checks to determine your insurance coverage. Since Next Step is a specialized healthcare provider, there are no co-payments for office visits.

Prosthetic devices and supplies are billed at the time of delivery, covered under the durable medical equipment (DME) portion of your insurance plan. With most insurances, there is usually a deductable and / or coinsurance due, unless a secondary insurance pays the remainder. Financing options are available for those who qualify.

Please note that some insurance plans do not pay for advanced bionic and prosthetic technologies. Our administrative staff works closely with your prosthestist to determine the best available options. We communicate our findings along the way and give you the tools needed to take charge of your prosthetic care.

For a more detailed explanation of our procedures, please consult the Reimbursement Process form.

Medicare Documentation for Prosthetics

 Insurance standards and paperwork requirements are ever-changing, and our administrative team stays well-informed about these modifications. Next Step has policies in place to ensure that guidelines are met and your prosthesis is paid for correctly. We appreciate your aid in meeting any insurance obligations and your patience in the process.

While revisions occur with private payers and other government plans, Medicare continues to develop the most stringent criteria. Therefore, as a Medicare provider, we must remain in constant contact with your primary care physician to document your prosthetic treatment and overall health. For us to provide you with excellent care in a timely manner, you may be asked to schedule appointments with your physician or contact the administrative department. Please note that we can no longer provide orthotic devices to Medicare beneficiaries.

As a Medicare provider, we offer Medicare patients the Medicare Supplier Standards.

Patient and Provider Forms

Next Step keeps your information confidential throughout your prosthetic treatment. We take our relationship with patients very seriously and maintain the highest level of HIPAA and compliance standards. We supply the following forms to patients at their initial consultations:

Insurance Plans We Accept

Next Step is contracted with many private and government-funded insurance companies and works with all workers’ compensation programs. We currently accept the following major insurances:

  • Aetna US Healthcare
  • Anthem
  • BCBS of Massachusetts
  • BCBS of Rhode Island
  • Champus / Tricare
  • Fallon
  • Harvard Pilgrim Healthcare
  • Mass Health
  • Medicare
  • MVP
  • Neighborhood Health Plan
  • Network Health
  • NH Medicaid
  • NY Medicaid
  • RI Medicaid
  • Tufts
  • United Healthcare
  • Veterans Administration (VA)
  • VT Medicaid

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