Out-of-Network Referrals
The majority of insurance companies utilize a system which entitles the patient to various benefits depending on whether a preferred practice is “In-Network” or “Out-of-Network”, whereby the insurance company pays an allowed amount and the patient picks up the shortfall eg Insurance 80% / Patient 20% or Insurance 70% / Patient 30%, etc.

As prosthesis fabrication is an exceptional specialty many insurance companies do not offer a local "participating provider". For that reason we write to the insurance company concerned and request an "In-Network Gap Exception/Waiver" ie we request that they accept In-Network Benefits from our facility on behalf of the patient. This enables the patient to pay a lower percentage of the co-pay. Occasionally an insurance company requests that we “negotiate” their fee by reducing ours.

We pro-actively work on the behalf of the patients to ensure they receive as much coverage as possible. Should you require any further information, please call our offices at 1-888-770-6049.

In the majority of instances we propose a similar rate to that of a contracted provider. Should you require any assistance or have questions regarding obtaining a prosthesis from our center, please do not hesitate to contact us.