What Medicare and Insurance Require
Medicare
- Confirmed benefit coverage
- Documentation to ReBuilder-DME
- Trial use of the ReBuilder for 30 – 60 days
- Re-evaluation visit to the doctor 30 – 45 days after receipt and the beginning of the use of the ReBuilder
- Re-evaluation documentation to RBM-DME
Insurance
- Confirmed benefits coverage
- Documentation of need to ReBuilder-DME
- The need for a trial use is dependent on Insurance Plan
- The need for a re-evaluation is dependent on Insurance Plan
What the Requirements Mean
- Documents to ReBuilder-DME
- Medicare and Insurance Card copies (front and back)
- Prescription
- Medical record notes from last 6 months related to the condition the ReBuilder will treat
- Delivery of ReBuilder product (s)
- Sign and return
- Proof of Delivery
- Privacy Policy
- Begin ReBuilder sessions as instructions describe
- Document sessions in Treatment Record
- Sign and return
- Physician re-evaluation of customer 30 – 45 days after receipt of ReBuilder and beginning of sessions
What You Need To Do
- Contact your doctor to let him and his office know that you want a ReBuilder and confirm if office visit is required
- Return Proof of Delivery documents to ReBuilder-DME as described
- Begin using ReBuilder as instructions describe
- If required, make a 30 Day appointment with your doctor for a re-evaluation 30 – 45 days after beginning to use the ReBuilder
- Record use of ReBuilder in provided Treatment Record form
- See your doctor for the 30 Day visit
- Obtain and send, or have the doctors office send, the completed Certificate of Medical Necessity to RBM-DME
What We (RBM-DME) Need To Do
- Confirm via voice or email that your completed Intake Form has been received and is awaiting documentation
- Confirm your benefits
- Confirm with you what your quoted benefits are and what your financial obligation may be
- Communicate with you and your physician if documents are not received or are not complete or accurate
- Notify you when your ReBuilder will be shipped to you
- Bill Medicare / Insurance for the 30-Day trial period for the ReBuilder
- Confirm with you that you will be seeing your doctor within the 30 – 45 day time-frame
- Contact you and your doctor if ReBuilder-DME does not receive the completed CMN within seven (7) business days of your 30-Day appointment
- Bill Medicare / Insurance
Required Customer Agreement
The customer agrees to:
- Take responsibility for getting all the answers to questions about both the ReBuilder and the insurance billing process that are individually important,
- Communicate your interest in the ReBuilder to your doctor,
- Obtain and provide, or assist in obtaining all required medical necessity records and documentation,
- Sign and return required documentation as outlined,
- Comply with all requirements outlined by the ordering physician and the manufacturer in the use of the ReBuilder,
- Make and keep the 30-Day re-evaluation appointment with your doctor if required,
- Pay your portion of the bill as determined by Medicare or your insurance,
- Pay your bill as agreed

