What is Neuropathy?Peripheral NeuropathySymptomsCommom CausesCommom TreatmentsThe ReBuilder-A CureOxygen TherapyAttention PhysiciansAnatomy of a NerveCarpal TunnelOther ResourcesLink ExchangingAbout UsContact UsHome PageORDERS 

  

.

Most Private Health Insurance Companies Cover the Rebuilder. Medicare "B" also covers the Rebuilder.

ReBuilder treatments in a clinic and product re-imbursement for home use are routinely covered by most insurance companies and Medicare under the codes used for electrical stimulation.

ReBuilder is Registered with the FDA as a prescription device for the following uses:

  • Symptomatic Relief for Chronic Intractable Pain
  • Post-Traumatic & Post-Surgical Pain Relief
  • Increasing Local Blood Circulation
  • Muscle Reeducation
  • Relaxation of Muscle Spasms
  • Prevention or Retardation of Disuse Atrophy
  • Immediate Post-Surgical Stimulation of Calf Muscles to Prevent Venous Thrombosis
  • Maintaining or Increasing Range of Motion

 

The ReBuilder qualifies for reimbursement under the "DME Billing Code" E0720.

The ReBuilder is fully registered with the FDA as both a TENS device (DME Code E0720) (for pain) and separately, as an EMS (DME Code E0745) for muscle atrophy with intact nerve.  Most insurance companies recognize, understand, and prefer the TENS description.

Although the FDA groups the ReBuilder with TENS devices (because of their limited number of classifications) the function of the ReBuilder is exactly the opposite of a common TENS device.  TENS is meant to close nerve channels, while the ReBuilder is designed to open nerve channels.

You will not need a prescription to purchase your ReBuilder, but you will need a prescription to provide to your insurance company as part of your claim.

* Note: We do not bill your healthcare provider. You file a claim for reimbursement.

If your physician prescribes a ReBuilder for you, he will write a prescription and provide you with a Certificate of Medical Necessity, and most commercial insurance companies will reimburse you according to the terms of your policy, usually 60-90% of the purchase price. Secondary coverage may pick up the rest. 

Contact your provider, it you are unsure if it is covered.  In order to know exactly IF and HOW MUCH will be covered, please contact your healthcare provider and ask what your coverage is for a pain control device with "DME Code E0720".  (The cost is $1299)  If they ask, "Is it a tens device?", you can say yes to confirm that they are looking at the correct code.  Chances are, they will know about the Rebuilder already.

 

The format and codes your physician will need are as follows.

The 1st Three are Required

Diagnosis:   "chronic intractable pain"     (DX Code: 338.4)

 Prescription:   DME Code E0720. FDA description is TENS.   "ReBuilder, brand specific, for pain." (no generic substitutions)

Medical Necessity:  "This device is medically necessary for the treatment of intractable pain unresponsive to drugs, surgery, and/or physical therapy.  Patient has responded well to this treatment."

Optional Paperwork. Can strengthen claim.

History of Failed meds: To further strengthen your claim, we suggest your doctor also include a brief history of failed medications or other attempted modalities.  (This can be part of the "medical necessity" letter.)

Evaluation Study: To further strengthen your claim, we suggest your doctor also include a brief evaluation study showing improvement. sample

 

Click Here for a Printable Version of These Codes for Your Physician

 

This is the fasted way to get reimbursed...

1. Confirm coverage with your provider. 
 
2. Talk to your doctor about the Rebuilder and ask if he/she will write the prescription. 
  
3. Purchase the Rebuilder and then make a copy of your sales receipt to include with
    your claim.
 
4. Gather the sales receipt, the prescription, letter of Medical Necessity, and any other
    supporting documentation, and then submit your claim. (Sometimes your doctor's
    office will file the claim for you, sometimes you do it.  Ask your doctor or
    provider about this.)

5. Reimbursement is sent to you by your health insurance provider.  

** The need for a "trial use" and a 30-60 day re-evaluation is required for some Insurance Plans.  Some plans will not pay until improvement benefit is documented by your physician. This is why many people use the Rebuilder for 30 days and then share results with their physician, then file the claim. This significantly strengthens your claim. (sample) 

Return to top

Medicare sets the maximum allowable price and covers about 80% of that amount once your annual deductible has been met. Then, if you have a secondary, back up insurance, that usually pays most of the balance, but varies by company, plan, and individual. Each supplemental plan is different, and each person's deductible balance may be different so it is difficult to say what your portion would be. As an average, most patients will be responsible for about $100-200 out of pocket that is due after Medicare and other insurance claims have been completed in about 30 days after receiving their ReBuilder.  

* Note: Our billing partner DOES bill Medicare directly.

Medicare Requirements:

  • Documents to DME Supplier (Durable Medical Equipment)
    • Medicare and Insurance Card copies (front and back)
    • Prescription
    • Medical record notes from last 3 office visits related to the condition the ReBuilder will treat
  • Delivery of ReBuilder product (s)
    • Sign and return
      • Proof of Delivery
      • Privacy Policy
  • Trial use of the ReBuilder for 30 – 60 days. Begin ReBuilder sessions as instructions describe.
  • Document sessions in Treatment Record provided
  • Physician re-evaluation of customer 30 – 45 days after receipt of ReBuilder and beginning of sessions.
  • Re-evaluation documentation sent to DME Supplier.

In general, this is what you can expect in order to jump through the Medicare hoops:

1. Confirm benefit coverage (confirm here before anything else). NOTE: if you already know what you need to know and want get going, you can go to step 3.)

2. Contact your doctor to let him know that you want a ReBuilder, and confirm if an office visit is required.

3. Forward these 4 things to the DME Supplier:

  • Medicare and Insurance Card copies (front and back),
  • Prescription from Physician,
  • Medical record notes from last 3 office visits related to the condition the ReBuilder will treat,
  • Any fees due up front.

4. Upon receipt of your Rebuilder, return Proof of Delivery documents to DME Supplier.

5. Begin using ReBuilder as instructions describe.

6. Make a “30 Day” appointment with your doctor for a re-evaluation 30 – 45 days after beginning to use the ReBuilder.  (You can make this follow-up appointment during step 2, to ensure you have an appointment time available.)

7. Record use of ReBuilder in provided Treatment Record form.

8. See your doctor for the “30 Day” visit.

9. Obtain and send, or have the doctor’s office send, the completed "Certificate of Medical Necessity" letter to DME Supplier.

 

What the DME Supplier Will Do:
  • Confirm via voice or email that your completed Medicare Intake Form has been received and is awaiting documentation.
  • Confirm your benefits with Medicare.
  • Confirm with you what your benefits will cover and what your financial obligation will be, if any.
  • Communicate with you and your physician if documents are not received or are not complete or accurate.
  • Notify you when your ReBuilder will be shipped to you.
  • Confirm with you that you are using the ReBuilder as outlined and described.
  • Bill Medicare / Insurance for the 30-Day trial period for the ReBuilder.
  • Confirm with you that you will be seeing your doctor within the 30 – 45 day time-frame.
  • Contact you and your doctor if DME Supplier does not receive the completed Certificate of Medical Necessity within seven (7) business days of your 30-Day appointment.
  • Bill Medicare / Insurance for the balance left on the Rebuilder and equipment.

 

Once your unit is approved by Medicare, your monthly supplies are provided as needed.  Conductive garments like socks and gloves will need a separate prescription for each re-order, but can be replaced when medically necessary.  Other supplies like self adhesive pads and batteries will only require a phone call from you to us to send them right out under Medicare benefits.

Return to top

 

 

Confirm Medicare Coverage Here:

The information requested on the Medicare Intake Form is required by both Medicare and Insurance Plans. Providing this information will begin the short process of verifying your coverage levels, co-pays, deductibles, etc...  Once verified, and any and all related up-front fees are determined, and the necessary paperwork is gathered that you will need to proceed with your claim.  We or the DME Supplier will call to go over this with you.

This does not obligate you to purchase a ReBuilder; you may make that decision once all the details have been gathered.

We will need a copy of your Medicare Card.  Please print this form, fill it out completely, and fax it to the number provided.  Or, you can scan it and email to us as an attachment to: frequencyrising@aol.com

 

 

Back to Rebuilder Page

Statements about neuropathy and others topics are for information only and should not in any way be used as a substitute for the advice of a physician.  Statements about neuropathy and the ReBuilder have not been reviewed by the FDA. Suggestions and ideas presented here should not be interpreted as medical advice, meant for diagnosing illness, or for prescriptive purposes.  The ReBuilder system’s electrical stimulation has been proven 95% effective in recent clinical studies in reducing and even reversing the symptoms of peripheral neuropathy.