Overview
The Short Answer: Navigating the HCPCS Code Problem
There is no specific HCPCS (Healthcare Common Procedure Coding System) code for a ByAcre rollator. This makes it really tough for us / insurance companies to ID reimbursement.
This is a challenge that applies to many high-end, premium mobility products that fall outside of the standard, covered-in-full equipment category.
The Path to Potential Reimbursement: A Step-by-Step Guide
While direct billing isn't an option, you can pursue reimbursement directly from your insurance company. Our team at NextGen HME is here to provide the necessary documentation to make this process as smooth as possible.
✅ Get a Prescription for a Rollator: Before you begin, get a prescription for a rollator from your doctor or a physical therapist. This is a critical first step for any potential reimbursement claim.
🛒 Purchase Your ByAcre Rollator: Purchase the ByAcre rollator of your choice directly from nextgenhme.com. You can also visit our North Olmsted store for an in-person purchase.
📄 Send Us Your Prescription: Send us the prescription you obtained from your doctor. You can send it to us via fax at 216-400-5885 or by email at sales@nextgenhme.com.
🧾 Request Our Insurance Reimbursement Receipt: Once we have your prescription, we will provide you with a specialized Insurance Reimbursement Receipt. This document will list everything you bought, along with other key information.
📬 Submit Your Claim to Your Insurance Representative: With our detailed receipt in hand, you can provide all the necessary information to your insurance representative for the potential of reimbursement.
Please Note: There are no guarantees that this process will result in full or partial reimbursement. The outcome depends entirely on your specific insurance plan and coverage policies.
What to Expect from the Reimbursement Process
This process is often referred to as "out-of-network" reimbursement. Many insurance companies have specific policies for this, and your claim's success can vary. We recommend speaking with a representative from your insurance company to understand their out-of-network / No coded DME policies before you begin the process.
It is important to manage your expectations and understand that while we provide the tools for you to make a claim, the final decision rests with your insurance provider.
There are no guarantees this will work.
Why ByAcre's Quality is Worth the Extra Step
The reason a ByAcre rollator doesn't have a standard billing code is because it is not a standard product.
It's an ultra-lightweight, carbon fiber, Danish-designed mobility device that provides far more benefit than a typical rollator.
For people who truly need to conserve energy, have a difficult time lifting, or require superior stability, the investment is worthwhile.
Common Questions About Insurance & Rollators
What is a HCPCS code?
A HCPCS code is a standardized code used by healthcare providers and suppliers to identify medical equipment, procedures, and services for billing purposes.
We often need these to ensure an item can be billed correctly.
Can NextGen HME submit the claim for me?
No, we cannot bill insurance as we are not set up / designed to take insurance.
Due to the lack of a specific HCPCS code for ByAcre rollators, submitting as claim is a case by case basis for your insurance to approve. We can only provide you with the necessary documentation for you to submit.
What if my claim is denied?
A denial does not mean you have no options. You can work with your insurance provider to understand why the claim was denied and, in some cases, you may be able to appeal the decision.
What is our Medicare / NPI number?
As we are private pay only, we are not required to have a Medicare Number or NPI number.
On a form we may mark those areas as N/A.
This also applies to TAX ID and W9 forms.
Are byAcre Rollators covered by my insurance?
No, they are not.
Please read above to review why and next steps for possible reimbursement.
Do I need a prescription?
To quality for this type of reimbursement, yes, you will be required to have a an authentic prescription signed by your care physician.
