When someone chooses to work with Rehab Medical to regain their mobility freedom, one of the first steps is to connect with our insurance team. This highly qualified team works directly and efficiently with patients to ensure they get a mobility solution that fits their unique needs covered by their insurance.
Currently, the team staffs more than 50 employees, making it the second largest department at Rehab Medical. From a structural standpoint, the department has five distinct teams: Verification, Follow-Up, Review, Submissions, and Approval. Below is a brief description of each team and how they contribute to the insurance process.
Verification - This team examines each patient’s insurance provider to ensure it’s an active insurance plan. This step is taken to see if there could potentially be obstacles down the road that would deny patient equipment. From there, insurance coverage is determined, and out-of-pocket expenses are outlined.
Follow-Up - This team ensures the patient’s insurance is approved. They will oversee prior authorization submissions and indicate if the status is pending, approved, or denied. This step is done two to three times a week, and the team will check in to update the patient throughout the process.
Review - This team collects and gathers documents during the verification process. These documents are reviewed thoroughly to ensure all information is correct and ready to submit to insurance.
Submissions - This team is responsible for reviewing the patient’s information, ultimately confirming if it is correct for insurance companies to process. Employees on this team are trained and educated about every requirement and guideline required for a patient to be approved by traditional insurance companies such as Medicare, Medicaid, and private insurance companies.
Approval - This team confirms that all information is correct with the insurance companies we submit documents to. Approvals are the final insurance authorization check before the equipment is ordered.
While these five teams are considered the backbone of the company, the work they do on a day-to-day process can get monotonous at times, which is why their team invests so heavily in having a super-rich culture with a strong sense of organization and direction. Each month the team gets together and creates a calendar of events to build teamwork and establish comradery. These activities include appreciation dinners, bowling outings, themed parties, and more!
A team member shares her thoughts, “The sense of teamwork and camaraderie is second to none. Our excellent environment helps you learn, grow, and accomplish your goals effectively. Our leadership enables you to understand the insurance process profoundly so we can make a difference and improve as many lives as possible.”
Over the last three years, our leadership team has worked jointly with the coalition of patients, providers, and complex rehab technology (CRT) advocates to ensure we continue to make a difference in the lives of our patients when it comes to insurance approvals.
As of May 17th, 2023, that hard work has paid off. Centers for Medicaid and Medicare Services (CMS) passed a legislation confirming power seat elevation systems would be covered under both traditional Medicare and Medicaid Advantage plans. With the passing of this legislation, mobility users who once struggled with reaching elevated areas such as cabinets and shelves are no more! This is a game changer and a massive win for mobility users nationwide.
In light of the CMS legislation passing, we are confident more mobility users will reach out for mobility needs, which will increase demand for our insurance team. So we asked a member what they thought the future holds for the team. “Insurance is everchanging. I expect this to still transpire in the future of complex rehab technology. From a team perspective, I see us streamlining the processes and continuing to develop the knowledge we share throughout our team.”
As we continue to carry out our mission of improving lives, developing knowledge, and streamlining the processes coupled with CMS’s new legislation passing, we fully anticipate exponential growth in the coming years as it relates to the patients we serve and the employees we invest in.
With the anticipation of this growth happening, we are always looking to add to this dynamic team. We take pride in employing individuals who have a passion for helping others and express a desire to evolve their skills. If this is of interest to you, we invite you to explore our careers page for our vast options of opportunities!