Reimbursement Tips:

1)Document, Document, Document the more there is to support your problem the better your chances of payment,

2)Include the company supplied CMN filled out completely.

3)Have a letter from your physician stating that he has been following your condition and list everything you have done and tried to regulate your bowels. Supply a list to your physician as to what your tried and the results (these should be documented in your patient file and be accessible for you),

4)Get a copy of any Hospitalizations for impactions or bowel complications, these show that you have a problem that is not controlled, submit these with your claim.

5)Do not accept the first denial on any claim to your insurance as you have the right to appeal it and continue till you are satisfied with the result,

6)Presently Medicare is not paying until the last review before a judge, you will need to pay cash for your product and buy it from a dealer who will file your claim unassigned, you will need to buy your supplies until it is paid for and this can take a year. If you don’t buy supplies you will show that you don’t need the product and it will be denied as not necessary.

7)Some Medicaid Programs will cover the Trolley with a Prior Authorization, you will need to get your dealer to pursue this for you, with Medicaid you do not have to provide the product till the Prior Authorization is approved and they will know what they will be reimbursed for it at that time.

8)Some Private Insurance will pay for the Trolley System AND you can do a Predetermination Billing for it, You assemble all your information and attach it to a 1500 form and stamp the 1500 in “RED” “Predetermination Billing”. You can then find out what and if they will pay based on your documentation and no one will have to be out anything.

What is the story with Medicare reimburse?

This is a very sad story. We have personally visited the office of Medicare and add a group of doctors review Pulsing Water Therapy™ and they were very enthusiastic.

They informed us that we would surely obtain National Approval and about 90 days after a National Medical Review Meeting that was coming up. Later we were to discover that there was no national meeting. They were practicing a delay tactic.

We later discovered that one of the doctors in the meeting was also a consultant to the medical companies and if we were to pay back Dr. $250,000 she would prepare a report that would help us gain national approval... unfortunately, we did not have $250,000 to pay that person.

It is very sad to us that a medical program that is to supposedly help people such as we disabled could be operating so “under the table”. Now for the truth if you have Medicare and a secondary insurance provider.

We have a dealer in California who is the mother of a spina bifida child and her child was help so much by Pulsing Water Therapy™ that she sent out to help other children with this problem. She is a Medicare Dealer and she has found that submitting an application to Medicare and obtaining a disapproval document... that she can turn to the secondary insurance provider and most of the time they will provide the necessary equipment and supplies.

If you want to attempt Medicare approval you must first obtain a local durable medical equipment dealer who is willing to work with you.

We have discovered that Medicare will approve reimbursement if your dealer is willing to submit about 3-4 appeals and especially if it goes to the courtroom with a Medicare judge. These judges always scold Medicare stating that our Pulsing Water Therapy™ is a “Prosthetic Medical Device” and that Medicare cannot deny any person a prosthetic medical device.

The US Congressional definition of a prosthetic medical device is a medical device that replaces the function of a permanently disabled internal organ. The very first prosthetic medical device was the dialysis machine that replaces permanently dysfunctional kidneys. You have a permanent dysfunctional internal organ... your nerve damage bowel!

Your path for obtaining reimbursement for your personal Pulsing Water Therapy™ Medical Device and monthly disposable kits... starts with your personal doctor or a local gastroenterologist.

Helping your doctor in the beginning is a must for you!

It is very important for you to download a PDF copy we have of a “Certificate of Medical Necessity” for your doctor to complete a medical order of Pulsing Water Therapy™ for you. You will then deliver this document to your selected medical equipment dealer for them to submit to your insurance company.

The reason is very important for you to study the Certificate of Medical Necessity and provide as much of this information on a separate piece of paper for your doctor when you visit them for the Certificate of Medical Necessity Order which is an absolute need for reimbursement.

Please understand the definition of a prosthetic medical device so that you can explain that to your doctor and why you need this device for a healthy and life supporting lifestyle.

The Certificate of Medical Necessity has summaries of published medical clinical for your doctor to read and feel more comfortable about the safety and efficacy of Pulsing Water Therapy™.

We also provide in this package of documentation a list of insurance companies that have already reimbursed for Pulsing Water Therapy™ to help you in your durable medical equipment dealer with reimbursement submission.

This may appear to be a difficult process; however, once you obtain your personal Pulsing Water Therapy™ it will make such a difference for you.