Insurance

The administrative staff at Next Step Clinics is prepared to assist with any billing inquiries and insurance-related issues. We educate patients about their expenses and encourage involvement in the insurance aspects of prosthetic and orthotic 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 orthotics and 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.

Orthotic and prosthetic (O&P) devices and supplies are billed at the time of delivery and usually covered under the durable medical equipment (DME) portion of your insurance plan. It is important to note that some insurances may have an O&P specific benefit that differs from general DME benefits. With many insurances, there is a deductible and/or coinsurance associated with DME and O&P benefits. Our administrative team will check your insurance benefits and provide you with an estimate of your out-of-pocket cost for the device or supplies. 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 orthotic and prosthetic care.

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

Medicare Documentation for Orthotics and 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 orthotic and 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.

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