Insurance Access & Coverage Resources

We have all had frustrations getting healthcare paid for, whether it is getting access and coverage for appointments, procedures, equipment, and/or medications.

Parents, patients, and medical providers spend hours putting together documents and speaking on the phone trying to convince payers that this is what is needed to keep us, our children, or our patients, as healthy as possible.

It’s a complicated and often an overwhelming process that makes you just want to throw in the towel. But we can’t. What is important to know is that this is a process and policy determinations are not always final.

To make this process easier, PPMD has assembled resources that will help families and medical providers at each stage of the healthcare access process. Included below are resources aimed at guiding you through this complex process – complete with sample letters and links to relevant publications and other resources.

We are working closely with health insurance payers (public and private) to increase their understanding of Duchenne and how access to available and emerging interventions, therapies, and equipment can improve health outcomes for our community.

As our engagement continues and we learn more, we will update and produce additional tools and resources for utilization by our community.  

Accessing New Therapies

With the first FDA approvals of Duchenne therapies, the Duchenne community has entered in a new environment for access and reimbursement. With this brave new world at play, PPMD has been leading the effort to educate and guide the community through these unchartered waters.

Accessing Medical Equipment

Providing wheelchair seating systems to patients that include the necessary components is incredibly important. However, obtaining the equipment and devices necessary can often times be a frustrating process. PPMD has worked with parents and providers in our community to develop sample templates for letters of appeal for parents, physical therapists and medical providers.

Overview of the Fundamentals of Access

In this two-part webinar series, we invited our consultant and expert, Michael Adelberg with FaegreBD Consulting, to a conversation on a number of topics to provide you with a basic understanding about the path to access.