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Reimbursement

13 March, 2015

Canada

FerriScan is reimbursed in all Canadian provinces as an 'Out-of-Country Medical Service'. The treating clinician must forward an application for each patient to the province's Ministry of Health (MOH) for approval. Once approved, the MOH will grant a timeframe for the patient to have their FerriScan and/or Cardiac T2*. 

To help with the application process, we've compiled a list of resources that may help you with your prior approval submissions:

Ontario

Prior Approval for Full Payment of Insured Out-of-Country (OOC) Health Services – Rescheduled FerriScan

Prior Approval for Full Payment of Insured Out-of-Country (OOC) Health Services – Annual FerriScan

Prior Approval for Full Payment of Insured Out-of-Country (OOC) Health Services – Repeat FerriScan

Prior Approval for Full Payment of Insured Out-of-Country (OOC) Health Services– Blank form

British Columbia

Out-of-Country Health Services Funding Application – Prefilled

Out-of-Country Health Services Funding Application – Blank form

Alberta

Out-of-Country Health Services Claim Form – Prefilled (If it doesn't open, try using Acrobat Reader) 

Out-of-Country Health Services Claim Form – Blank form (If it doesn't open, try using Acrobat Reader

Out-of-Country Health Services Application Process – Information

Manitoba

Pre-Approval FerriScan Information – FerriScan Info Pack (Word Doc)

Manitoba Out-of-Province Medical Referrals – Information

Saskatchewan

Pre-Approval FerriScan Information – FerriScan info Pack (Word Doc)

Coverage for Services – Unavailable in Canada – Information

Quebec

Pre-Approval FerriScan Information – FerriScan Info Pack (Word Doc)

Medical services covered outside Quebec – Information

Nova Scotia

Prior approval for out-of-country services – Information

 

Germany

Generally, in-patients receive full reimbursement for under DRG and have no out-of-pocket expenses.

For ambulatory diagnosis with FerriScan, if the patient stays less than 24 in the hospital, there is no general reimbursement. Either the patient is paying it out-of-pocket as so called IGeL or he can do an individual case by case application (Einzelfallantrag) with his health insurance.

 

UK

FerriScan is reimbursed at public hospitals through the local NHS Trust system.

 

USA

FerriScan has been used in the United States since 2005, when FDA clearance for FerriScan was obtained. Since that time, approximately 10,000 FerriScans have been performed for US patients at a number of US hospitals and radiology facilities.

The cost of the MRI scan (or part of the cost) is usually covered by insurance companies (payers). Pre-authorisation is recommended, as is common for MRI testing. However, the cost associated with the FerriScan image analysis may not be covered, resulting in the hospital or patient having to cover this cost, together with any co-pay associated with the imaging.

FerriScan has now been deemed eligible for reimbursement by some US Insurance Companies:

  • Health Net. Prior authorization is required to confirm the medical necessity of a FerriScan
  • Kaiser Permanente SE Atlanta. Prior authorization is required to confirm the medical necessity of a FerriScan
  • Medical Mutual of Ohio. No prior authorization is required

Resonance Health is currently working on gaining a suitable CPT code for the MRI post processing work. 

 

Rest of World

Resonance Health is continuing to work with the clinical community and patient organisations towards appropriate funding pathways for patients who need to access to FerriScan and Cardiac T2* services.

Please email info@resonancehealth.com for further information.

 

Updated: 22nd-December-2017