Minimally invasive surgical fusion of the SI joint is becoming a covered benefit by more insurance companies every year. The best way to find out is to call your insurance company and ask if they provide a Positive Coverage Policy for sacroiliac joint fusion surgery with the iFuse Implant System®.
Prior Authorization: Some insurance companies require that you or your surgeon request "prior authorization" before they cover iFuse.
In the request, the surgeon describes the nature of the patient’s condition and why it is necessary to perform the iFuse procedure. The insurance company reviews the request and makes a determination to coverage under the patient’s insurance plan.
Insurance Appeals: When patients are forced to appeal their insurance denials while struggling with SI joint pain, the experience can be overwhelming. We would like to help.
If you are a patient who has experienced an insurance denial, or have been denied access to the iFuse procedure through your commercial or Medicare plan, we have resources for you.
The following insurance support resources are downloadable and printable, and are designed to help facilitate the insurance authorization and appeals process.
Patient Insurance Authorization Workbook - This workbook is designed to help you navigate the insurance authorization process for your iFuse Procedure.
ISASS Policy 2016 Update: Minimally Invasive Sacroiliac Joint Fusion
- Coverage policy of the International Society for the Advancement of
Spine Surgery (ISASS) for Minimally Invasive Sacroiliac Joint Fusion,
originally published in 2014 and later updated July 2016.
Before any assistance can be provided, SI-BONE must receive signed authorization from the patient (or the patient’s parent/guardian).
In connection with its ongoing efforts to facilitate patient access to its technologies by providing education and training to healthcare professionals, SI-BONE Inc. provides certain assistance designed to help you obtain patient coverage decisions from third party payors.
Here are some of the ways SI-BONE can help you with your insurance approvals and appeals process:
Ask your insurance carrier whether your policy covers minimally invasive sacroiliac joint fusion surgery. Please contact us for a list of payers covering, to see if your insurance carrier provides access to the iFuse Implant System.
If you are a patient experiencing an insurance denial, and are interested in Patient Insurance Coverage Support (PICS), please contact us today.
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