Because laws, regulations and payer policies regarding reimbursement change frequently, it’s important to consult with your payers and coding specialists. For reimbursement assistance, payment information and HCPCS codes used for GRAFIX PL membrane and GRAFIX◊ Cryopreserved placental membrane, please refer to the HOPD or physician office billing guides.
To verify patient benefits and determine potential coverage and reimbursement parameters for payers in your area, contact the Smith+Nephew Reimbursement Hotline at 866-988-3491 with questions and submit an Insurance Verification Request Form for your patient via fax at 866-304-6692.
Reimbursement varies by payer, contract terms and site of service. As such, providers are responsible for verifying coverage with the patient’s insurance carrier, including the applicability of any non-coverage decisions for GRAFIX PL and GRAFIX membranes.
The Smith+Nephew Reimbursement Hotline is an information service only. Benefits information will be provided by the insurer or third-party payer. Results of these services are not a guarantee of coverage or reimbursement, and Smith+Nephew disclaims liability for payment of any claims, benefits or costs.
The reimbursement world is ever-changing, and we have all the latest information for you to stay updated.
State Coverage Information:
Payer coverage information in this Local Payer Coverage Summary was obtained from Medical Policies published on the payer's website or published by Policy Reporter®, accessible by subscription. Smith+Nephew makes no opinion, statement, promise, or guarantee that reimbursement will be made by a payer. Coverage on a Medical Policy is not a guarantee of a member’s benefits. The provider is responsible for verifying coverage with the patient’s payer source.
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