REIMBURSEMENT AND FORMULARY SUPPORT
Experience an exceptional
level of support
Blue Earth Diagnostics is committed to providing the support you and your patients require
With unparalleled experience in the field of prostate cancer molecular imaging, Blue Earth Diagnostics, Inc. offers extensive education, training, and support
POSLUMA has been granted pass-through status in the Medicare Part B hospital outpatient setting, effective October 1, 2023
REIMBURSEMENT SUPPORT
Connect with your local FRM
Access support starts with your Field Reimbursement manager (FRM). This is your resource for access support, providing information and resources to help you navigate benefits and coverage for POSLUMA.
Your FRM will provide support with:
- Coverage policies for payers
- Clinical guidelines for radiology benefit managers
- Education on prior authorizations, billing, and coding
- Support for appeals, denials, and peer-to-peer process
- Provide in-person and virtual reimbursement training
The POSLUMA reimbursement guide provides the resources and information you need:
- Coding Information Sheet
- Prior Authorization Best Practices
- Scheduling Tip Sheet
- PET Imaging Program Implementation Checklist
- Letter Templates
- Letter of Medical Necessity
- Letter for Appeal of Denial
- Sample Billing Forms
- Blue Earth Reimbursement Support Helpline Information
- Fillable Forms
- Diagnostic PET Order Form
- Patient Benefit Investigation Form
Get the POSLUMA Resource Guide
Reimbursement support helpline assists with access questions for individual patients*
Call 1-855-495-9200 or fax 1-877-309-7514, Monday through Friday from 9 am to 8 pm Eastern time, for support throughout the benefit approval process.
*Helpline provides information about prior authorization/appeals requirements, and, at the provider’s option, submits PA forms completed by the provider to the payer.
Download the Patient Benefit Investigation form today
Contact your local Field Reimbursement manager for billing, coding, local payer information, and reimbursement review
Regularly review your payer contracts to ensure appropriate reimbursement for POSLUMA
Utilize Reimbursement Support Hotline for benefit investigation/prior authorization services
Even if no authorization is required, confirm that the patient meets the coverage criteria
Become familiar with your payer mix and their coverage criteria
Conduct a benefit investigation for every patient
Always try to obtain a prior authorization for both the CPT and HCPCS code
Schedule meeting to discuss POSLUMA reimbursement with Field Reimbursement manager
FORMULARY SUPPORT
Access important resources
Download all formulary components or choose one or more of the individual components below.
The information on this website contains factual information and is not intended to be legal or coding advice. Blue Earth Diagnostics does not guarantee coverage or reimbursement for POSLUMA. The existence of billing codes does not guarantee coverage and payment. Payer policies vary and may change without notice. It is the provider’s responsibility to determine and submit accurate information on claims. This includes submitting proper codes, modifiers, charges, and invoices for the services that were rendered. It is the provider’s responsibility to ensure that all information on a claim is accurate. It is the provider’s responsibility to check with the payer to determine whether the information contained on the claim is accurate. It is the responsibility of the provider to document the medical necessity of POSLUMA in the medical record.
