Reimbursement - Pre-Authorization Assistance

Boston Scientific is committed to making life smoother by providing healthcare professionals comprehensive reimbursement support for the Precision Plus^TM Spinal Cord Stimulator (SCS) System. Please click on the links below to access pre-authorization forms and guides.

Main

Getting Started with Pre-Authorization
UPDATED	Pre-Authorization Introductory Packet	187 kb	(updated 1/1/12)
UPDATED!	Insurance Authorization Form (optional)	134 kb	(updated 1/1/12)
UPDATED!	HIPAA Business Associate Agreement	50 kb	(updated 6/6/11)
NEW!	Pre-Authorization Submission Form	89kb	(updated 1/1/12)
Pre-Authorization Toolkit
NEW!	Pre-Authorization Toolkit: Pre-authorization process made easy!	63 kb	(updated 1/1/12)
NEW!	Benefit Verification Form	460 kb	(updated 6/6/11)
NEW!	Sample Pre-Authorization Request Form for Trial Procedures	54 kb	(updated 6/6/11)
NEW!	Sample Pre-Authorization Request Form for Permanent Procedures	62 kb	(updated 6/6/11)
NEW!	Sample Appeal Letter	38 kb	(updated 6/6/11)
Pre-Authorization Resources
NEW!	Reimbursement Customer Support Guide for Spinal Cord Stimulation	54 kb	(updated 1/1/12)
UPDATED!	Pre-Authorization Reference Guide	181 kb	(updated 1/1/12)
NEW!	2012 Payer Medical Policy Reference Guide for Spinal Cord Stimulation	196 kb	(updated 1/1/12)
UPDATED!	Checklist for Letter of Medical Necessity	86 kb	(updated 1/1/12)
NEW!	2012 HPCPS to Precision Crosswalk	51 kb	(updated 1/1/12)

Boston Scientific Corporation
Health Economics & Reimbursement
+1 (866) 287-0778

For more information on the approved use, risks and benefits of the Precision Plus SCS System, click here.

Reimbursement - Pre-Authorization Assistance

Getting Started with Pre-Authorization

Pre-Authorization Toolkit

Pre-Authorization Resources