The first step toward patient
insurance approval

MyCartilage Care can provide patient support by helping to manage the insurance process. It offers:

  • Patient benefit investigation
  • Predetermination and prior authorization management
  • Reimbursement support

STEP 1:

Download and complete the patient enrollment form

Click here

STEP 2:

Select the patient’s insurance carrier and confirm the specific medical inclusion criteria

STEP 3:

Fax the enrollment form and all supporting documentation to
855-803-9485

Resources to assist with approvals and denial appeal can be found at:
MyCartilageCare.com/approval

  • Insurer inclusion/exclusion criteria
  • Dictation guide for common insurer inclusion criteria
  • Letter of Medical Necessity assistance
  • Peer-to-Peer guidance
  • Patella clinical review
  • Reimbursement guide

For assistance with patient insurance approvals, call your MyCartilage Care Case Manager at 877-872-4643 or visit MyCartilageCare.com/approval

 

insurance approval success rates*

87% of all MACI cases were approved on initial submission

 

MACI insurance approval specific to patella cases:

  • 84% Approved on initial submission (25-30 days)
  • 4% Approved on appeal (+20-25 days)
  • 10% Not appealed & 2% Denied after appeal


MACI is widely reimbursed and included on a majority of national insurance plans. To see a list of insurers, please visit MyCartilageCare.com/approval.
 

*Data on file. MACI cases activated between January 2019 and December 2019. Insurance approval is defined as payor pre-authorization for the MACI procedure.