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Patient insurance approval process*
MyCartilageCare can provide patient support by helping to manage the insurance process. MyCartilageCare provides patient benefit investigation, predetermination and prior authorization assistance, and reimbursement support.
Step 1
Download and complete Patient Enrollment Form. Submit Patient Enrollment Form and all requested documentation to MyCartilage Care. For transcription guidance, please see the MyCartilage Care Dictation Roadmap, located in the Resource Library below.
Step 2
From the list below, select patient’s specific insurance carrier for medical inclusion criteria (if carrier is not listed, please call MyCartilage Care at 877-872-4643 for more information). For patients who do not meet the specific criteria of their insurer, additional documentation should be submitted with the Patient Enrollment Form. Letter of Medical Necessity Guidance, Letter of Medical Necessity Template, and Patella Clinical Packet are in the Resource Library below.
Please choose patient insurer:
- Aetna
- Allways Health Partners
- Anthem
- Blue Cross Blue Shield Federal Employee Program
- Blue Cross Blue Shield of Alabama
- Blue Cross Blue Shield of Arizona
- Blue Cross Blue Shield of Arkansas
- Blue Cross Blue Shield of Florida
- Blue Cross Blue Shield of Georgia
- Blue Cross Blue Shield of Kansas
- Blue Cross Blue Shield of Kansas City
- Blue Cross Blue Shield of Louisiana
- Blue Cross Blue Shield of Massachusetts
- Blue Cross Blue Shield of Michigan Blue Care Network
- Blue Cross Blue Shield of Minnesota
- Blue Cross Blue Shield of Mississippi
- Blue Cross Blue Shield of Nebraska
- Blue Cross Blue Shield of North Carolina
- Blue Cross Blue Shield of North Dakota
- Blue Cross Blue Shield of Rhode Island
- Blue Cross Blue Shield of South Carolina
- Blue Cross Blue Shield of Tennessee
- Blue Cross Blue Shield of Vermont
- Blue Cross Blue Shield of Wyoming
- Blue Cross of Idaho
- Blue Shield of California
- BlueShield NE New York
- Capital Blue Cross
- Carefirst
- Carelon Benefits Management
- Cigna
- Emblem Health (ConnectiCare)
- EMI Health
- Evicore
- Excellus BCBS
- Fallon Health
- Health Alliance
- Health Care Services Corporation: BCBS of IL, OK, MT, NM, TX
- HealthNet
- HealthPartners
- Highmark
- Highmark of Westen NY
- HMSA
- Horizon (Carelon Benefits Management)
- Horizon (Turning Point)
- Humana
- Independence Blue Cross
- Iowa Health and Human Services—Medicaid
- Kaiser Permanente—Foundation Health Plan of Washington
- Medica
- Medical Mutual of Ohio
- Molina Healthcare
- NIA (National Imaging Associates, Inc.)
- Payors Without Formal Medical Policy Criteria
- Premera
- Quartz
- Regence
- SelectHealth
- Tufts
- United
- United Medical Resources (UMR)
- Wellmark
Step 3
Fax the completed patient enrollment form to MyCartilageCare at 855-803-9485.
*Insurance approval is defined as payor pre-authorization for the MACI procedure. Nothing contained herein is intended, nor should it be construed, to suggest a guarantee of coverage or reimbursement for any product or service. Check with the individual insurance provider regarding coverage.
Resource library
Materials are available to help support insurance reimbursement and billing. Additional questions may be directed to MyCartilageCare at 877-872-4643.
I am a patient and my doctor has taken a biopsy of my knee cartilage for MACI
A dedicated MyCartilageCare Case Manager is committed to offering comprehensive support tailored to your individual insurance requirements and treatment goals. Call 877-872-4643 or email info@MyCartilageCare.com.
Patient authorization is required to store biopsies and assist with insurance approval. To download authorization forms to submit via mail or fax, click here.