The medical insurance submission procedure is increasingly complex, time-consuming and burdensome for everybody involved. The policies, procedures, and approval criteria of payer organizations vary widely. Physicians and their staff are confronted with widely varying insurance requirements.

At the same time, patients are understandably daunted by the idea of navigating the insurance process on their own.

In an effort to streamline and simplify the insurance submission process, our staff at Advanced Respiratory, Inc. a Hillrom company:

• Compiles and submits all paperwork necessary to obtain prior authorization
• Follows up with the insurance company to ensure the submission proceeds smoothly through the process
• Clarifies insurance company requests for information in an attempt to require retrieval of only the most pertinent patient records
• Follow through to help resolve insurance issues
• Our appeals team assists the patient with an appeal and follows through on their behalf to receive funding from insurance companies

Appeals Process

When a payer denies coverage, it can be stressful for the patient. Often, these decisions can be appealed. We will be there if that happens. In the event the payer denies an authorization request, our appeals staff will advocate for patients and submit an appeal to the payer to present a case for coverage.

Professional and Passionate

Professional backgrounds of Hillrom reimbursement personnel include nursing, case management, and Medicaid and commercial insurance. Each individual is committed to working with patients, their insurance provider, and their health care team to obtain appropriate reimbursement for the Monarch Airway Clearance System, The Vest Airway Clearance System, Synclara Cough System, and Life2000 Ventilation System. We are passionate about improving our patient’s lives and we want to help make this process simple.

HCPCS Codes

These are the Healthcare Common Procedure Coding System (HCPCS) that Hillrom uses to identify our equipment for medical billing.

• Monarch Airway Clearance System: E0483 - High Frequency Chest Wall Oscillation Air Pulse Generator System
• The Vest System: E0483 – High Frequency Chest Wall Oscillation Air Pulse Generator System, (includes Air Hoses and inflatable vest), each
• The Vest System Garment: A7025 – High Frequency Chest Wall Oscillation System Vest, replacement with patient owned equipment, each
• Synclara Cough System: E0482 – Cough Stimulating Device, alternating positive and negative airway pressure
• Synclara Cough System Interface: A7020 – Interface for Cough Stimulating Device, includes all components, replacement only
• Life2000 Ventilation System: E0465  – Home ventilator, any type, used with invasive interface (e.g. tracheostomy tube)
• Life2000 Ventilation System: E0466  – Home ventilator, any type, used with non-invasive interface (e.g. nmask, chest shell)