Payment Plans and Reimbursement

Cala Trio therapy is a novel technology, a first-in-class device. Like all novel technologies, there are limited coverage policies in place. Cala Health is actively working with insurers to expand coverage policies.

How do different insurance payors handle reimbursement for Cala Trio devices?

  • Commercial Payer + Medicare Advantage (Part C): Cala has become an accredited
    provider with major national payers like Aetna, Blue Cross, Blue Shield, United Healthcare, and others. Using the HCPCS codes, Cala has been processing individual claims. Health plan structures determine the out-of-pocket cost for the patient.

  • Preferred Provider Networks (PPO): Cala Health is now “in-network” with MultiPlan and
    Zelis PPO healthcare plans. Being in-network means that the price has been prenegotiated. However, health plan structures determine the out-of-pocket cost for the patient.

  • Veterans Administration: The VA has paid for veterans to access the Cala Trio device
    through the prosthetics department at each VA center.

For patients without insurance, those that don’t want to wait for prior authorization, or those who prefer to pay cash for the device: within 60 days of receiving the initial Cala Trio Therapy System, the Cala Trio device may be returned for any reason by calling Customer Success at 888-699-1009 to make shipping arrangements. After receiving the returned device Cala Health will void the agreements.

 

MKG-1533 Rev A Dec 2021

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