Receiving Insurance Coverage for a Biomat

The Biomat with its Far Infrared and Negative Ion Therapy is a viable alternative for pain management, stress management and body detoxing to the generally accepted pharmaceutical solutions available. Although Far Infrared Therapy has widely been accepted in the orient as a standard for pain management, stress management and body detoxing it is just now finding its way into the medical community in America. Its absence has been due to the strength of the Pharmaceutical Industry, the choice for economic gain over the patient’s best interest and general skepticism of both medical practitioners and the public at large towards alternatives. Therefore, at this time receiving coverage from insurance companies for a Biomat presents a challenge. Although some practitioners have received medical insurance coverage for Far Infrared Therapy it is accomplished through negotiation with insurance providers and then with the risk of insurance companies reversing decisions after payments are made. The Biomat Store’s position is that practitioners attempt to bill insurance at their own risk. However, the documentation below is based upon the experience of those able to collect insurance from their providers.

With all that being said, it is rather simple to collect compensation for a Biomat via an automoble insurance policy if injuries were suffered and a payment warranted. However, auto insurance payments are usually a limited abount and the amount billed for a biomat will be deducted from the total sum available for complete medical assistance.

Typically the steps to achieve Insurance Coverage for a Biomat are as follows:

  1. Discuss the Biomat as a viable option with your medical practitioner.
  2. Once a positive decision to use the Biomat as a theapy of choice has been reached a determination must be made to either:
    • Purchase a Biomat immediately and wait for reimbursement knowing that full reimbursement, partial reimbrusement or none at all may be remitted by the insurance provider.
    • Delay purchase until a determination of remitance is communicated by the insurance provider.
  3. The Practicing Physician will then need to provide the following to the Insurance Provider.
    • A prescription
    • A letter requesting Insurance Coverage
    • A Consultation Letter
    • FIR data sheet (if deemed necessary)
    • A Medical Invoice provided by the Biomat Representitive
    • Examples of Insurance Coverage


CPT CODES

Many insurance carriers will cover the expense of Far Infrared Treatment of their subscribers charged to code 97026 or 97034, “Infrared Radiation Therapy” when prescribed by a physician. Other codes used include:

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CPT Code DESCRIPTION
97026 Medicine: Application of a modality to one or more areas; infrared
97034 Medicine: Application of a modality to one or more areas; contrast baths, each 15 minutes
77600 Hypothermia
99070 Materials and Supplies – Far Infrared Therapy Pad as equipment
HCPCS Code DESCRIPTION
E0221 Infrared Heating Pad System


SAMPLE LETTER REQUESTING INSURANCE COVERAGE

An example of “The Letter Requesting Insurance Covereage” is provided below. This letter may be all that is needed when submitting for an Auto Accident Claim or to more liberal Insurance Providers:

{Date}{Insurance Company, i.e. State Farm Insurance Company}{Street Address, i.e. P.O. Box 9608}{City, State Zip Code, i.e. Winter Haven, FL 33883}

Attn: {Insurance Representitive’s Name if available}

RE: {Claim Number if appropriate in case of an accident}

Dear {Insurance Representative}:

I am recommending and prescribing that {patient’s name} obtains a Biomat to aid in the management of her/his {condition, i.e. chronic musculoskeletal condition}. This would allow {patients name} to treat her/his {condition} at home as often as needed. Continued use in an ongoing manner is recommended because the healing effects are cumulative.

The Biomat is an FDA – approved medical device (FDA/UL License E203622, USFDA, Medical Device 2954299). The full description of this product is: Insurance Procedure 99070, Amethyst Biomat Professional 7000 MX with Conducting Pillow for proper cervical alignment. The Biomat is used in intensive care units and for post-operative treatment in hospitals in Japan and Korea and is gaining recognition in the United State rapidly.

I am enclosing two examples of insurance coverage on the Biomat for your review. My recommendation is medically necessary, however, should you have any questions or require additional information not to exclude submital on a standard insurance claim form, please feel free to contact me at my office.

Thank you, for consideration regarding this matter.

Sincerely,

{signature}

{Practicing physician}


THE CONSULTATION LETTER

The Consultation Letter should be submitted for tougher cases, medical insurance claims, or when Insurance Coverage for a Biomat is in doubt with providers such as Blue Cross Blue Shield or Medicare. This is a typical format used by most MD’s. Appropriate headings are listed below with headings suggesting wording about the Biomat supplied. The Physician may not need to use all of the headings.

{Date}{Insurance Company, Consultin Physician or Patient}{Street Address, i.e. P.O. Box 9608}{City, State Zip Code, i.e. Winter Haven, FL 33883}

Patient: {Patient’s Name}

Chief Complaint: {Claim Number if appropriate in case of an accident}

Dear {Insurance Co. Representitive, Consulting Physician, or Patient}:History of Present Illness:Diagnostics:Past Medical History:Past Surgical History:Medications:Drug Allergies:Social History:Family History:Psychiatric History:Review of Systems:Physical Examination:

  • Vital Signs:
  • General:
  • Specific Area Examinations:

Impression:

Recomendations: With the patients longterm and continued use of prescription medication and the potential for complications due to these medications, I am recommending and prescribing that {patient’s name} obtains a Biomat to aid in the management of her/his {condition, i.e. chronic musculoskeletal condition}. This would allow {patients name} to treat her/his {condition} at home as often as needed. Continued use in an ongoing manner is recommended because the healing effects are cumulative.

The Biomat is an FDA – approved medical device (FDA/UL License E203622, USFDA, Medical Device 2954299). The full description of this product is: Insurance Procedure 99070, Amethyst Biomat Professional 7000 MX with Conducting Pillow for proper cervical alignment.

Closing Remarks:

Sincerely,

{signature}

{Attending Physician}


FIR DATA SHEET

The following are excerpts of citations made by Sherry A. Rogers, M.D., Sand Key Company, Inc., P.O. Box 40101, Sarasota, FL 34242 touting the benefits of FIR therapy as a viable alternative to pharmaceutical treatments of many disorders. This may be submitted to the Insurance Provided as additional information necessary to make a determination as to the viability of the Biomat as a treatment.

1) Researchers from Columbia School of Public Health in New York report that 95% of cancer is caused by diet and environment (Perera).

2) Likewise thousands of scientific papers and books document how environmental chemicals obtained through our air, food, and water can trigger every disease known to man and even the serious “undiagnosable “, “untreatable” diseases which have no label (Kaloyanova, EPA, Arlien-Soborg, Repetto, Casarett, Sullivan).

3) And the mechanisms of how unavoidable environmental chemicals, cause disease are well-described(Schook, Halliwell, Halsted, Liebman, Bemis, Steventon, Betarbet, Brucker, Kohn, Piscator, Baldi, Arnold, Howdeshel1, Colburn, Wiseman, Wartenberg, Birnbaum, Siblerud, Bigazzi, Packer).

4) Further research shows that environmental pollutants are so ubiquitous that there’s no place on earth to escape them, not even at the polar ice caps. Even the breast milk of nursing Arctic women have been found to be dangerously high in, for starters, PCBs and mercury (Muckle, Perskey, Abe, Gnandjean, Weisglas-Kuperus).

5) Furthermore, EPA studies of breath analyses of New Jersey residents show 93% harbor perchloroethylene in their bodies, 89% had benzene (a known cause of leukemia), and 29% were exhaling carcinogenic trichloroethylene, in addition to numerous other carcinogens (Wallace). In fact there are no longer any oceans, seas, lakes, rivers, animals in the wild nor humans on the face of the earth that do not harbor detectable levels of potent carcinogens and other disease-producing environmental chemicals (U.S. EPA 1984,1987, Rogers).

6) The governments EPA studies of hundreds of Americans have shown 100% of fat human biopsies reveal styrene, dioxin, xylene, dichlorobenzene and more (U.S. EPA, 1984, 1987). Most of these are carcinogen; and can mimic any symptoms imaginable.

7) As well, the EPA and other researchers have been startled by the amounts of phthalates or plasticizers in humans that are potent environmental hormone disruptors, again mimicking a multitude of endocrine diseases as well as triggering cancers (Blount, Jones, Raloff).

8) Whether one studies heavy metals, pesticides, PCBs, dioxins, volatile organic hydrocarbons or other xenobiotics, research studies and toxicology textbooks confirm that these very same chemicals can produce any disease from cardiac disease, autoimmune, recurrent infections, allergies, and cancer, to endocrine and neurologic diseases, congenital defects, low I.Q., thyroiditis, and every disease of every organ and system in between (Steingraber, Colburn, Baker, Pavia, Colon, Rea, Ashford, Gupta, Osius, Waalkes, Kipling, Visser, Hoyer, Peters, U.S. Department Health Human Services, Lieberman, U.S. EPA, 1983, Pelletier, Solonen 1995, 2000, Crinnion, Sood, Sug, Enestrom, Fredericsson, Rier, Echeverria, Jobling, Schantz, Rogers).

9) When clinicians have been stumped or they have exhausted all that medicine has to offer, with their backs against the wall, they reversed recalcitrant medical conditions by getting these unavoidably ubiquitous chemicals out of the body. From drug addicts to firefighters, from high blood pressure to congestive heart failure, from undiagnosable neurologic problems and cognitive deficits to chemical sensitivities;, the formula has been the same: get rid of the underlying environmental chemical causes that have stockpiled over a lifetime (Kilburn, Rea, Schnare 1984, 1986, Root, Roehm, Tretjak, Hubbard, Tei, Ikeda, Imainura).

10) Unfortunately, the modus operandi in medicine is to find a drug to turn off the damaged part that is producing symptoms. A simple, example is the prescription of calcium channel blockers, the number one drug used by cardiologists for angina, hypertension, congestive heart failure, or arrhythmia. But as with any drug, this does not fix anything that is broken. It merely poisons normal physiologic pathways, thereby forcing the chemistry in a direction that attenuates symptoms.

Since nothing has been done in terms of getting rid of the underlying cause, the disease continues. In addition the missing fatty acids and minerals in the cell membranes that house the calcium channels are not identified and repaired. Nor are the sequestered membrane chemicals that caused the damage, like unavoidable PCBs and mercury, gotten rid of (Bemis). If this were not enough perpetuation and acceleration of damage, the side effects of drugs are not innocuous. For example, calcium channel blockers have been shown by MRI to cause definitive shrinkage of the brain and loss of brain function, a side effect rarely mentioned by clinicians or news media (Heckbert, Havlik).

11) Far more therapeutic and ethical is the Far Infrared Therapy as reported by Mayo Clinic researchers where they reversed hypertension, pulmonary wedge pressure, endothelial (arterial) dysfunction, and congestive heart failure (Tei, Ikeda, Imamura). This is particularly impressive since these patients had exhausted everything that medicine had to offer. And clearly they are not candidates for a regular sauna, as even high temperature heat waves increase their death rates.

12) But it should not come as a shock that this type of information is ignored, since studies in the Journal of the American Medical Association document how the practice guidelines for American medicine are made by physicians who receive compensation from the drug industry (Choudhry, JAMA 2002; 287: 612-617). In addition so is the FDA, the very government regulatory body that approves drugs, riddled with advisers with financial ties to (and is heavily lobbied by) the very drug industry that is seeking its approval (Cauchon, Cohen, Epstein, Haley, Glenmullen, Breggin, Stelfox). And as the New England Journal of Medicine and Journal of the American Medical Association warn, even the hired clinical investigators for new drugs may have their price (Bodenheimer, Chalmers, Freidberg, Angell).

13) Let’s return to congestive heart failure as our continuing example of a dead-end disease, since it kills more people in each year than cancer. The average person only lives five years once the diagnosis of congestive heart failure is made and is usually on well over $600 a month in medications alone, not to mention frequent doctor visits, x-rays, blood tests, and hospitalizations. There is literally nothing in medicine that reverses the process of congestive heart failure once it has started. Instead, progressively more medications are piled on, making the average survival less than cancer. Median survival for cancer is six years; median survival for congestive heart failure is five years. Furthermore more people get congestive heart failure each year than get cancer. Contrast this bleak prognosis for congestive heart failure with the Mayo Clinic studies where pulmonary wedge pressure, shortness of breath, ability to discontinue medications and many other parameters of congestive heart failure improved with use of the far infrared therapy. In other words, it accomplished what no medication and no surgery could for a disease that is worse than cancer. Obviously not any old sauna will do, bemuse high heat is contraindicated and poorly tolerated by heart failure patients, and in fact is a cause of early death, as newspaper reports during heat waves testify. But because far infrared therapy provides safe, low temperature depuration through sweat of the very heavy metals, pesticides, dioxins, PCBs, plasticizers, and other environmental chemicals that caused the heart damage in the first place, it is successful. And in contrast to drugs, it has no side effects.

The far infrared therapy pulls otherwise permanent toxins out of the body by causing a molecular dance with molecules of water and xenobiotics stored in the surface fat. In this way it does not drag chemicals out of safe storage and into the bloodstream where they could cause exacerbation of symptoms. Instead, it causes a resonance, between the water and chemical molecules, enabling topical excretion via sweat where they can be wiped and showered away forever (Inoue). This is the only known and proven mechanism for getting rid of the vast diverse array of disease-producing toxins/environmental chemicals. Medicine has no other option for lowering the body burden of chemicals that underlie all disease.

In the Mayo Clinic studies, the far infrared sauna accomplished what nothing else in medicine could. No surgery, no drug is available to give this type of therapeutic result. Likewise, other studies with other xenobiotic, other occupations, other medical conditions which were also totally resistant to all that medicine had to offer were improved once the chemicals were depurated. In addition, the whole family can use the far infrared therapy and they can use it forever. For as research and history both testify, the world will never run out of ways of poisoning us.

14) In terms of expense, depending upon size and delivery method, the cost is only a couple of thousand dollars. Insurance companies allow $100,000 for chemotherapy, radiation, bone marrow transplants, tests and hospitalizations for the treatment of various types of cancer, for which they know the median survival will be six months to five years at best. Paying $100,000 for no cure is not cost-effective. They allow $1,000 a month for a rheumatoid arthritis drug that works by lowering the tumor necrosis factor (Enbrel), thereby increasing the chance of cancer. And they cover biological response modifiers at $10,000 per injection that often only buy the patient 2-3 months of life. Again, this means thousands of dollars with no cure.

In contrast, with the far infrared therapy we are talking about reversing disease, getting rid of the underlying causes and therefore getting rid of the symptoms, once and for all. We are talking about restoring the body to a level of chemicals it had maybe 20-50 years ago. A life sentence to medications that block physiologic pathways is avoided. And bear in mind that since medications do not fix anything, they allow the underlying problem to continue uncorrected and actually accelerate. Meanwhile, new symptoms and new seemingly unrelated diseases are the inevitable consequence of this biochemical faux pas.

15) Furthermore, drug side effects are the leading cause of death. The Journal of the American Medical Association shows that far in excess of 106,000 people die per year in hospitals from diagnosed drug side effects (Lazarou). But as former FDA head Dr. David Kessler has shown in the same journal, less than one percent of adverse medication reactions are reported to the FDA. As other researchers have shown, over 16,000 people die each year just from gastrointestinal hemorrhaging from NSAIDs, while another 100,000 get congestive heart failure from them (Page, Van den Ouweland, Feenstra, Heerdink). As well NSAIDs cause osteoporosis and hip and knee degeneration, necessitating joint replacement (Shield). And these are just some of the side effects of one category of drugs. NSAIDs, as an example of only one group of medication, are fatally toxic to thousands of people each year by damaging joints, lungs, kidneys, eyes, hearts, and intestines. And they are covered by insurance.

No wonder the Journal of the American Medical Association study shows that death by prescribed drugs in the hospital is the No.4 cause of death in United States (Lazarou). But that study ignores the hundred thousand people who get congestive heart failure each year just from the NSAIDs (Page, 2000). This would more than double the statistic making recognized drug reactions in hospitalized patients the No. 3 cause of death. And this does not look at death outside of the hospital, nor deaths unrecognized as being attributable to drug side effects. As Dr. David Kessler, previous head of the FDA, has reported in the Journal of the American Medical Association a maximum of 1-5% of adverse medication effects get reported to the FDA.

On the flip side, sweat is the only proven mechanism that removes heavy metals, PCBs, pesticides, and other foreign chemicals from the body. Nothing else does. The far infrared technology is the only one that allows sweet depuration of xenobiotics at low, safe temperatures, even tolerated by heart patients. That is why the far infrared therapy has been able to accomplish what nothing else in medicine can in terms of reversing the true underlying causes of disease.

16) Sometimes the reason for insurance rejections is that the therapy is not “reasonable and customary”. But I should not be penalized for physicians’ lack of knowledge. For example, according to the Journal of the American Medical Association (June 13, 1990), it is reasonable and customary for 90% of physicians to fail to look for something as rudimentary and lifesaving as a magnesium deficiency in over 1033 patients hospitalized for cardiovascular problems. The sad fact is that many of these patients died from myocardial infarction secondary to arrhythmias from their undiagnosed magnesium deficiencies. Instead they were loaded up with many symptom-masking drugs.

It is “reasonable and customary” for over 16,000 patients to die in the hospital each year just from gastrointestinal hemorrhaging secondary to non-steroidal anti-inflammatory drugs. It is “reasonable and customary” for over 100,000 patients to get congestive heart failure each year secondary from nonsteroidal anti-inflammatory drugs (Page, 2000). And it is “reasonable and customary” for patients to have $50,000 of bypass surgery, even though they start re-clotting their new vessels within six months.

And it is “reasonable and customary” for doctors to prescribe Mevacor, Pravachol and other HMG COA reductase inhibitors to lower cholesterol, when many proven and safe nutrients will do the same without the side effects. Meanwhile the cholesterol-lowering drugs inhibit the gene for this enzyme, thereby turning off the body’s production of coenzyme Q10 (Willis). This medicationinduced coenzyme Q10 deficiency in turn leads to depression, fatigue, mitochondrial dysfunction, high blood pressure, cardiomyopathy, periodontits, congestive heart failure and more (Tomasetti, Folkers, Judy, Nakamura, Mortensen). But the patient thinks he is getting a bargain at over $100 a month because his cholesterol level looks good on paper.

Drugs do rot cure anything, they merely turn off poisoned and malfunctioning pathways. That is why their classifications are anti-inflammatory, ant-acid, beta-blockers, alpha-blockers, calcium channel blockers, angiotensir. inhibitors or ACE inhibitors, HMG COA reductase inhibitors (cholesterollowering drugs), selective serotonin reuptake inhibitors or SSRI, etc. And by not fixing the underlying problem, they allow it to worsen. The innocent patient accumulates side effects from the drug as well. And we know why the practice guidelines for every medical disease make it look as though every symptom is a deficiency of some drug (Choudhry). Arthritis becomes a Celebrex deficiency, heartburn becomes the Prilosec deficiency, and depression becomes a Prozac deficiency. Fortunately there are many heavily referenced books that document the unethical practices of the drug industry in perpetuating the pharmacologic feast for patients, rather than finding and getting rid of the underlying causes (Glenmullen, Berkson, Breggin, 1991, 1998, Moore 1995,1998, Epstein, Haley, Fagin, Moss, Cohen, Wolfe).

I hope that with this summary you can appreciate the logical, scientific, cost-effective and moral reasons to cover the far infrared therapy.


THE MEDICAL INVOICE

Below is a sample of a Medical Invoice which is attainable from the Richway Distributor specific to the patient.

Medical Invoicet


EXAMPLES OF INSURANCE COVERAGE

Below and on the following page are copies of checks remitted by insurance companies for a purchase of the Biomat. With this the Insurance Company can realize understand they are not alone in backing FIR therapy as a viable, cost effective solution to their customers’ well being.

The physician should now be equipped with everything needed to submit for Insurance Coverage and hopefully receive it.

Florida Farm
Liberty

Below is where you can find additional and more specific information about the Biomat

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