Cost

Coverage will be determined on a case-by-case basis. Your physician will submit a coverage request to your insurance company on your behalf prior to the procedure to determine if you are eligible for coverage.

It’s important to make sure you understand your coverage and any insurance provider requirements, including “prior approval.” Please note that Medicare does not require a prior approval process, but will need to be contacted by your doctor.

Approval Process

Typically, your doctor will work with you to get prior approval from your insurance company. He or she will send a letter of medical necessity explaining why Medtronic Bowel Control Therapy is right for you and confirming that more conservative treatments have been unsuccessful.

Sometimes insurance companies are unfamiliar with Medtronic Bowel Control Therapy (Sacral Neuromodulation) or the InterStim^® System, and may turn down your initial request. Don’t be alarmed if this happens to you. Often, sending more information as part of an appeal can be helpful. Members of the Medtronic Coverage and Authorization Services Group will guide your doctor through the approval process.

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