The main values of providing custom orthotics are the postural support, protection, and comfort they offer to your patients. Another important aspect of the orthotics process, however, is the help you can give your patients in getting reimbursed for these products.
Many patients hope that their orthotics will be considered a covered expense by their insurance companies. For some policies that is true; but there are exceptions. It is a good idea to suggest that patients read through the various policy documents they were given. If there is no specific exclusion, it is very possible that some coverage is available. Either way, it is often helpful if patients have something in writing which details the reasons you are recommending custom orthotics. This makes them more excited and more willing to pay the cost, even if insurance denies the expense. Sending a copy of this written explanation to the insurance company does seem to help with payment in many cases.
Figure 1 is an explanatory letter for custom-fitted orthotics. I recommend you re-type this onto your letterhead, and use it whenever a patient, a family member, or an insurance adjustor needs to be educated regarding the need for orthotics. Of course, any specific information you can provide to make the explanation more customized for each individual patient will be very helpful. Your patients will appreciate the “extra mile” you have gone to help them in their dealings with insurance companies. TAC
Dr. John Danchik is the seventh inductee to the American Chiropractic Association Sports Hall of Fame. He is the current chairperson of the United States Olympic Committee’s Chiropractic Selection Program. He lectures extensively in the United States and abroad on current trends in sports chiropractic and rehabilitation. Dr. Danchik is associate editor to the Journal of the Neuromusculoskeletal System and the Journal of Chiropractic Sports Injuries and Rehabilitation. He has been in private practice in Massachusetts for 24 years. You may reaach Dr. Danchik at (617) 489-1220 or e-mail [email protected].