Reimbursement of Mirena IUD

vrolen

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We are running into a situation where our cost for a Mirena IUD is greater than our carrier reimbursements. Is there a way to bill these with the cost information to obtain a higher reimbursement rate?
 

mm0105

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Our Mirena rep told me that they (Bayer Pharmaceuticals) were getting in touch with insurance carriers to let them know that the rate increased. She said that it may take up to 3 months for all carriers to be on board with the increase. They offered a promotion in the beginning of March (up to the 12th) that allowed us to buy up to 10 Mirenas per provider at the lower rate...to basically tide us over until all the insurance companies were aware of the change. Sorry that doesn't help too much. You may want to contact the insurance company and tell them the situation, even though it may not help right now.
 

vrolen

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Our biggest problem is AR Medicaid, since most of our patients that use this devise are Medicaid receipiants. Getting Medicaid to increase is going to be difficult to say the least!
Thank you for the information though, that is helpful. We did purchase several before the increase, but not sure how long the supply will hold out.
I have also researched on the Mirena website - they have a program where you order the device through them by prescription and they will do the billing for it to the ins and patient. That is a little inconveinent however to wait for it to arrive for each patient. But, push come to shove it is an option.
Thanks again
 

vrolen

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That is the other option, and I believe that is what we will do for the time being. However, it will be very cumbersome and the patient will have to make an additional appointment and come back after we receive the product to have it placed. But our doctors and patients really like this product, so until we can resolve the reimbursement issues, that is the way we will be doing it.
Thank you
 
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