Cost and Coverage

JDL Access is BlueWind Medical’s partner when it comes to prior authorization and understanding your coverage benefits. JDL Access will work with you and your physician to submit the required documentation needed for a prior authorization request. If the treatment is not approved initially, you have the right to appeal. The JDL Access team will guide and assist you throughout the appeals process, and work on your behalf as your authorized representative to submit appeals to your health insurance company until a final decision has been rendered.

Revi Access is only available to patients whose physician office is enrolled with the program. If your physician is not enrolled with Revi Access, it is likely they will conduct the prior authorization and appeals process themselves.

Prior authorization (also known as pre-authorization, prior approval, or precertification) is a process that health insurance companies use to determine whether a patient is eligible to receive certain procedures. Prior authorization is done to determine whether a service, treatment, procedure, or durable medical equipment (DME) is medically necessary.

Not all health plans require or allow for prior authorization. Traditional Medicare does not require prior authorization for Revi. However, Commercial plans and Medicare Advantage plans may require one. It is important to follow up with your physician’s office and insurance company to understand the process.

Not all health plans require prior authorization, so it’s important to work closely with your physician’s office to determine your insurer’s requirements.

Partnership with Revi Access is only available through your healthcare provider’s office. Your physician must be enrolled with the Revi Access to utilize the program’s services. If your physician is not enrolled with Revi Access, it is likely your physician’s office will work through the insurance process themselves.

There are three potential phases to the process including: prior authorization, internal appeal and external appeal.
Prior authorization
During the prior authorization, you will be asked to sign a Patient Consent and Authorization Form, which enables JDL Access to work directly with you and your physician to receive, and submit, necessary documentation for Revi. Once you sign this form, JDL Access may submit paperwork on your behalf to seek prior authorization with your health plan, and act as your designated authorized representative to appeal any denials.
Internal appeal
If the prior authorization request is denied, you may move into the internal appeal phase. During this time JDL Access will work directly with your physician to submit a thorough letter and supportive clinical documentation to demonstrate medical necessity for Revi. You may receive correspondence in the mail from your health insurance plan during this process.
External appeal
If the internal appeal requests are denied, you may have the right to request an external review by a third party independent review organization (IRO). JDL Access will work with you and your physician to initiate this request. The independent reviewer will decide if the payer should approve and cover the procedure. This is typically the last step of the pre-service appeal process.