Mobi-C® PAR (Patient Advocacy Resource) - Mobi

Mobi-C® PAR (Patient Advocacy Resource)
Helping patients gain access to Mobi-C Total Disc Replacement
The Mobi-C Cervical Disc is an FDA-approved technology
designed to relieve neck and arm pain associated with
degenerative disc disease or symptomatic cervical disc
disease, while allowing the potential for motion in the spine.
If your surgeon has identified you as a candidate for a
one- or two-level Mobi-C and you would like to learn more
about insurance coverage for this procedure, please consult
your Mobi-C Patient Advocacy Resource, or PAR.
CALL 502-231-6868
REIMBURSEMENT
®
Introduction to LDR’s Mobi-C Patient Advocacy Resource (PAR)
As a potential candidate for cervical disc replacement, LDR Spine is pleased to be able to introduce you to
a reimbursement support service. This support service, the Mobi-C Patient Advocacy Resource (PAR), is
intended to help you receive coverage in the event your insurer is not currently covering Mobi-C for one or
two levels.
Newer technologies like the Mobi-C artificial cervical disc can present challenges for obtaining
reimbursement until coverage is established by all of the commercial insurers. One of the most effective
ways of establishing coverage for you is appealing a denial through an external independent review.
LDR intends to support you through this process with your insurer. All we need to get started is a signed
authorization to proceed. We will contact your insurer on your behalf for a predetermination of coverage,
we will appeal it if it is denied, and we will keep you and your surgeon informed throughout the entire
process.
It is important to know that this process takes on average three to four months to complete. We will do
everything in our power to make this time as short as possible, and you are free to opt out of this process at
any point along the way.
This resource is available to you from Monday-Friday, 9am-7pm EST and can be reached as follows:
• Phone:
502-231-6868
• Fax: 502-231-4996
• Email: [email protected]
How will the Mobi-C PAR help me with my insurance company?
The Mobi-C PAR is a reimbursement support service that works on your behalf. The PAR will work together
with your surgeon, the surgeon’s office, and your insurance provider. If your insurance does not cover this
procedure to date, the PAR will help you by:
Requesting a prior authorization of coverage from your insurance provider
The PAR will contact your insurance provider to request a prior authorization of coverage for your procedure.
This will likely be denied, but getting a written denial triggers your right to have your case reviewed by an
expert.
Initiating an appeal(s)
If your prior authorization is denied, the PAR will coordinate the necessary appeals with your insurance
provider to pursue an overturn of the denied coverage.
Facilitating an external review
If coverage is still denied after the insurance company reviews your claim internally, the PAR will then
facilitate an external review with an independent reviewer.
Why should I use the Mobi-C PAR service?
•
The PAR’s proven approach is resulting in more overturned denials, faster case-by-case approvals, and
more universal policy changes to cover the procedure for all insured patients.
•
With each individual case that is submitted and overturned, patients like you come one step closer to
gaining universal access to this technology from your insurance provider.
What is my responsibility as a patient?
•
Call the Mobi-C PAR:
502-231-6868
•
•
•
Monday – Friday 9am – 7pm EST
During non-business hours, you may leave a detailed voicemail.
Calls will be returned within one business day.
Coordinate with your surgeon and the PAR to complete the required documentation.
Expect that this process could take 3-4 months on average, but know that the PAR will do everything it
can to expedite the process.
Keep in touch with the PAR, as they will with you!
Together, with patients like you, we will gain universal access to cervical discs
from insurance providers!
REF: MB RS 19 REV A 08.2015
®
United States
13785 Research Boulevard
Suite 200
Austin, Texas 78750
512.344.3333
France
Hôtel de bureau 1
4, rue Gustave Eiffel
10 430 Rosières Près Troyes, FRANCE
+33 (0)3 25 82 32 63
www.ldr.com
www.cervicaldisc.com
www.ldrcoding.com
China
Unit 06, Level 16, Building A,
Beijing Global Trade Center #36
North Third Ring Road
East, Dongcheng District,
Beijing, China, 100013
+86 10 58256655
Brazil
Av. Pereira Barreto, 1395-19º Floor
Room 192 to 196
Torre Sul-Bairro Paraíso
Santo André / São Paulo-Brazil
CEP 09190-610
+55 11 4332 7755
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LDR, LDR Spine, LDR Médical, a passion for innovation, Avenue, BF+, BF+(Ph), Bi-Pack, C-Plate, Easyspine, InterBRIDGE, Laminotome, L90, MC+, Mobi, Mobi-C, Mobi-L,
Mobidisc, ROI, ROI-A, ROI-C, ROI-MC+, ROI-T, SpineTune and VerteBRIDGE are trademarks or registered trademarks of LDR Holding Corporation or its affiliates in France, the
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