Contract Case Management

Insurance Carrier:

• Call with patient demographic, billing, and medical information as applicable
• Provide specific name of device(s) required if known
• Provide authorization number

Provider:

• Verify benefits coverage
• Obtain prescription and letter of medical necessity
• Obtain authorization number if none was provided by Insurance Carrier*
• During Patient Evaluation:
  • Assess patient knowledge of services provided
  • Assess patient needs for additional services or supplies
  • Assess patient needs for additional support services
  • Assure that all required patient training/teaching was completed.
• Send patient follow-up questionnaire
• Provide documentation to case manager when applicable.

Billing & Collection

• A Lehneis billing representative will verify coverage parameters, deductibles, and co-payments, co-insurance and bill the patient as necessary. Lehneis will not bill the patient more than the contracted rate established with insurers.
• Upon completion of services, Lehneis will bill the insurer either electronically or on a HCFA-1500 form with all appropriate information for claims processing to the correct claims processing center.
• Timely payments are expected as set forth in the provider-insurer contract.
• Patients are informed that, should coverage laps or otherwise be terminated, they will be responsible for payment.

Insurance Carriers may reach a Lehneis representative at any local phone number or at 800-775-LOPA. For simplification, multiple referrals may be handled through one phone call, or via fax at 516-621-5423.

* Lehneis requires an authorization number prior to services being rendered to a patient when applicable.
** Follow-up with a case manager will be provided to monitor continued necessity of the device(s) when requested.