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Questions about Medicare
- Does Medicare cover procedures that utilize American Medical Systems (AMS) products?
- What would a Medicare patient's copay be for procedures that utilize AMS products?
- I have questions about my Medicare benefits, who can I contact?
- Does my private insurance cover AMS products?
- What can I do if my procedure is denied or improperly processed?
1. Does Medicare cover procedures that utilize AMS products?
Medicare typically covers procedures that use AMS products when the patient meets medical necessity. In addition, Medicare has specific National Coverage Determinations (NCD) that list incontinence control devices as a covered benefit.
Incontinence
Medicare has a NCD for the Incontinence Control Devices (230.10). This NCD states that, “such a device is covered when its use is reasonable and necessary for the individual patient.”
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2. What would a Medicare patient's copay be for procedures that utilize AMS products?
Please click here to review Medicare patient copay estimates for procedures utilizing AMS products in the outpatient hospital or ambulatory surgical center settings.
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3. I have questions about my Medicare benefits, who can I contact?
You can contact AMS Health Care Affairs with questions at (888) 865-3373 regarding procedures that utilize AMS products. If you have other general questions or need help with your Medicare benefits there is FREE ASSISTANCE AVAILABLE. The State Health Insurance Assistance Program (SHIP) has counselors in every state and several territories that are available to provide FREE one-on-one help with your Medicare questions or problems. Click here to visit Medicare's website to locate a SHIP counselor in your area. Select SHIP from the Search by Organization Name dropdown to get started.
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4. Does my private insurance cover AMS products?
AMS recommends that you work with your physician's office to verify coverage and benefits prior to the procedure being performed. There are also steps you can take to minimize the chances of an improperly processed or denied claim.
Read your insurance policy. It's better to know what your insurance company will cover before you receive a service. It is also possible that some services may need to be approved by your insurance company before your doctor can provide them.
If you still have questions about your coverage, call your insurance company and ask a representative to explain it.
Remember your insurance company, not your doctor, makes decisions about what will be paid for and what will not.
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5. What can I do if my procedure is denied or improperly processed?
Call your doctors office and have them check to make sure everything was correctly coded.
Call your insurance and ask for an explanation as to why the claim was denied and inquire on your appeal options.
Contact AMS at (888) 865-3373.
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