General Support and CMR FAQ

 

 

Products:

 

Why do you require a prescription for some products?

FDA rules and liability issues require us to obtain a prescription for some of our products. We will work with you and your doctors to obtain necessary prescriptions.

 

What should I do if I have a problem or question about a specific product?

 

Please visit the individual support/FAQ pages for questions and support for the Therabite System, the Pacer CPM, and the Cold-Compression System. For other products, please visit their specific product pages for more help.

 

If these pages do not provide the information you need, please feel free to contact us your patient specialist, or call our main office at 1-800-206-8381.

 

Insurance Billing:

Please visit our insurance information page for more information on the process of pre-authorizations, pre-determinations, billing, and appealing claims to both private insurers and Medicare/Medicaid.

 

Does private insurance cover CMR products?

Private insurance (including workers comp, company funded, union plans, non- and for-profit insurance plans and HMO's) covers some CMR products. Each company, and often each individual plan, has various rules, policies and procedures for determining whether a product will be covered. Generally, the recovery products are not covered, and the motion products are on based on the diagnosis information.

 

Does Medicare cover CMR Products?

Medicare covers the TheraBite System. Medicare only covers CPM for the knee, and does not cover any recovery products.

 

Does Medicaid cover CMR Products?

CMR is not registered with any state Medicaid providers, and cannot bill Medicaid for products. In general, Medicaid does not cover any motion or recovery products.

 

What can I do to help get coverage for a product?

Your participation in the pre-authorization, pre-determination and billing process can significantly increase your chance of having the equipment covered. In addition, after CMR performs a 1st level appeal, we will help you file a 2nd level appeal and you can always file a complaint with your state's insurance regulator for a ruling to compel coverage.

 

What billing services does CMR provide?

CMR performs all the services to bill for our equipment up to a 1st level appeal, including pre-authorization, pre-determination, billing for providing the equipment, and a 1st level appeal (as each is necessary or required by an insurance carrier.)

 

CMR has extensive experience performing complex appeals for DME, and can also provide billing services for other DME vendors, doctors offices, and patients.

 

If my appeals have failed, what other options do I have to get the equipment paid for?

Generally, after a first level appeal, you have the option to file a second level appeal to the insurance company. You can lobby your company's HR administration for assistance with the insurance company. You can also often file a complaint with the state insurance regulator for a hearing to compel the insurer for coverage.

 

 

Medical Advice:

 

Can CMR recommend a doctor, surgeon, physical/speech/occupational therapist?

We work with a number of fantastic providers, however we unfortunately cannot recommend any health care providers.

 

Can CMR offer medical advice about my condition or symptoms?

As a private company and not a doctor familiar with your individual case, we are both legally and ethically prohibited from providing medical advice for the diagnosis or treatment of any conditions or symptoms. We recommend that you schedule an appointment with your doctor for advice and guidance for your particular case.

 

Which product is appropriate for my condition?

As a service to providers, CMR provides diagnosis indications for our products, and recommendations for specific indications based on cost and clinical evidence. However, we are not able to provide a product recommendation to any individual. Your doctor is responsible for evaluating your case and prescribing appropriate care. We can provide you and your doctor more information on our products to assist in the decision making process.

 

 

Shipping and Returns:

 

For Patients: CMR ships USPS first-class or priority mail for products sent to patients. We can also provide overnight or two-day shipping for an additional charge.

 

For Professionals: Shipping/Handling is charged in addition to the professional price and is determined based on the shipment. We offer overnight, two-day guaranteed, and two-day ground shipping. Please contact us for more information, rates, and the professional discount prices.

 

In general, orders received will be shipped the same day as the order, but is not guaranteed. In addition, overnight and guaranteed two-day orders must be received by 3:00 pm MST for shipping that day.

 

Because all our products are medical in nature, we can only accept returns for unopened equipment. We also will provide a replacement for defective equipment.