On this page you will find answers to Insurance and Billing questions. Please read below to answer most of our popular questions. If you cannot find the answer to your question here please review our other Frequently Asked Questions pages, email us at firstname.lastname@example.org or call us at Toll Free at 1-800-736-8367.
Insurance and Medicare Questions
What is Medicare?
Medicare is a Federal health insurance program for people 65 years or older, certain disabled people, and people with end stage renal disease (ESRD).
Do you accept Medicare or other forms of Insurance?
Yes. We are contracted with Medicare and most insurance companies. We will file all claims to all insurance companies on your behalf for all of our items.
Do you assist with Medicare and Medicaid claim processing?
Yes. We will complete all of the Primary and Secondary claim filing for all Medicare and Medicaid products, as well as all other insurance plans.
What is a Medicare deductible?
A deductible is the amount you must pay each year before Medicare begins paying its portion of your medical bill. Medicare has two separate deductibles, one for the Hospital Insurance and Hospital Claims (Medicare Part A) and one for the Clinical Insurance and Clinic Claims or Doctors visits and services (Medicare Part B). Your deductible reduces the amount Medicare pays for the claim, passing that amount onto the patient to make the remaining payment. Medicare will not pay on any claim until you have met 100% of your annual deductible. If you have any questions on the status of your deductible please contact Medicare at 1-800-MEDICARE (1-800-633-4227).
What is “assignment” on the Medicare Plan and why is it important?
A doctor or supplier that agrees to accept assignment of the Medicare allowed amount as payment in full must agree to Assignment of Medicare Benefits. If is an agreement between Medicare and Anodyne stating that Anodyne will accept Medicare’s allowed amount as payment in full for the products or supplies.
The patient or secondary payer is responsible for the coinsurance and deductible amounts. If you have both Medicare and Medicaid coverage, Anodyne must accept assignment of benefits for your product or supplies.
What is competitive bidding?
Competitive bidding is a process where by Medicare has selected a limited number of providers to provide nine categories of items. Call Anodyne for additional information regarding our participation in the competitive bidding program.
Doctors Orders and Prescriptions
Do I need a prescription to get a supply?
Certain covered items can be reimbursed by Insurance only if the doctor has furnished Anodyne Inc with a written prescription for the item, before delivery. There are multiple items that require a prior authorization or prescription. Please contact us Toll Free at 1-800-736-8367 if you have any questions on orders and prescriptions you need for specific products.
Do you accept verbal orders from physicians?
Anodyne can only accept verbal orders on some items in certain instances. we are required to follow-up and obtain a detailed prescription from the physician to have on file for documentation. If the verbal order is for disposable supplies, which are to be supplied monthly on an ongoing basis, we will only dispense the first month on a verbal order. we are required to obtain the written prescription for all orders after the first month. Anodyne will work with you and your physician to get all of the necessary documentation before the next reorder date.
What is a detailed prescription?
A detailed prescription supports the need for a specific product or service. It is a document provided by your physician. The document must include the patients name, Date of Birth, description of the item or service, length of need (if applicable), and must include the physicians signature and date.
My doctor wrote a detailed prescription for my item, is it covered by insurance?
Even thought your provider completed the detailed prescription it does not mean that it will be covered by insurance. every insurance carrier has different coverage criteria for every item. Many items which are covered by one insurance, are not a covered benefit under a different insurance. Anodyne will be happy to verify your benefit and coverage criteria before any service is rendered. Some insurances also require specific doctor orders or prior authorization.
What is a certificate of Medical Necessity?
A Certificate of Medical Necessity (CMN) is a form required by Medicare or other insurance carriers authorizing the use of certain durable medical items and equipment prescribed by a physician. This form is to be completed by your doctor or the doctors employee. Anodyne will coordinate with your doctor to see that all the necessary information is submitted to your insurance.
What form of payment do you take?
Anodyne accepts all major credit cards or personal checks as a form of payment. If you have further questions about our payment options please call us at 1-800-736-8367.