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Reimbursement support from BlueWind Medical

BlueWind Medical is committed to providing information and resources to assist with navigating the complex insurance process, and ultimately supporting patient access to the Revi System. Our team is here to answer questions about coding, prior authorization, billing, and claim denials.

Download the coding and reimbursement guide for Revi to better understand the process, coding, coverage, and billing.

Our Medical Documentation Checklist includes a comprehensive checklist outlining documentation and guidelines recommended to support insurance authorization and appeals for Revi.1 This checklist may help streamline the reimbursement process for both healthcare providers and patients.

This guide is intended for healthcare providers to utilize as reference to ensure what’s documented in the patient’s clinical history and medical notes best supports medical necessity, specifically through the authorization and appeals process.

Medicare billing process
for Category III CPT
codes2

Medicare Administrative Contractors (MACs) provide important billing information on their websites related to Category III CPT codes. BlueWind Medical recommends healthcare provides review these guidelines and recommendations prior to billing for Revi, and to frequently check these MAC processes as they may change.

Reimbursement support with Revi Access

BlueWind Medical’s patient access program, Revi Access (powered by JDL Access), will assist with increasing patient access to the Revi System through well-documented prior authorizations and patient-based appeals process. If interested, healthcare providers may speak to their BlueWind representative to learn more and complete the Revi Access Enrollment Form online to participate.3

What is Revi Access, by JDL Access?

Revi Access is an optional service for healthcare providers when submitting prior authorizations, pre-service appeals, or post-service appeals for Revi. The program is powered by our third-party partner JDL Access, who works directly with you and your patients insurance companies to increase access to Revi.

What does Revi Access provide?

The program offers a secure platform with a support hotline and streamlined communications with real-time case updates. It allows pre-service and post-service appeal submissions, eligibility and benefit verification, prior authorization submissions, and external review (IRO) submissions and services.

References

1. The Medical Documentation Checklist is intended to be a general resource for healthcare providers considering the use of BlueWind’s Revi™. This checklist is not a guarantee of insurance coverage or reimbursement.

2. The information contained in the linked resources is provided by third-party sources (CGS Medicare, First Coast Solutions, Novitas Solutions) and is not necessarily endorsed or supported by BlueWind Medical. While we believe this information to be generally reliable, we do not guarantee its accuracy or completeness. This information is intended for healthcare providers familiar with Medicare billing and coding practices. It is not a substitute for professional medical advice or your own independent verification of coverage and reimbursement policies. Healthcare providers are responsible for understanding and complying with Medicare’s rules regarding non-covered services and Category III CPT codes and are also responsible for staying current on coding and billing requirements. This includes, but is not limited to:

  • Verifying the applicability of Category III CPT codes to their specific practice and patients.

  • Ensuring the medical necessity of services using Category III CPT codes.

  • Submitting complete and accurate documentation to support such services when seeking reimbursement.

  • Staying current on coding and billing requirements, including potential prior authorization requirements for Category III CPT codes.

  • Consulting with their own billing and coding experts for specific guidance.

BlueWind Medical is not liable for any denied claims, negative coverage determinations, or damages or losses incurred as a result of using the information contained in the linked resources. By clicking any of the provided links, you acknowledge and agree to the terms of this disclaimer.

3. The information contained in this guide is presented for illustrative purposes only and is subject to change without notice. BlueWind Medical makes no statement, promise, or guarantee regarding reimbursement nor does this constitute legal advice. It is always the responsibility of the provider to determine if the services provided are accurately described by any specific code(s) and to report services consistent with specific payer requirements. In all cases, services billed must be medically necessary, actually performed as reported, and appropriately documented in the medical report. Payer policies vary and should be verified prior to treatment. Payment rates provided are Medicare national unadjusted payments.