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STABILITY BIOLOGICS, LLC, ITS SUBSIDIARIES AND BILLING PARTNER BREEZE MEDICAL, LLC (COLLECTIVELY, “STABILITY”) TERMS AND CONDITIONS OF THE REIMBURSMENT HOTLINE LIMITED WARRANTY

 

Order Entry Policy: For most efficient handling, all orders and correspondence pertaining to shipments should be communicated to:

 

Stability Biologics, LLC Customer Service Department, Tel: 855-267-5551, Fax:  855-267-4166, Email:  cservice@stabilitybio.com

 

The Customer Service Department is open weekdays (excluding U.S. national holidays) between the hours of 8 a.m. and 5 p.m. Central Standard Time.

For the Reimbursement Hotline and Insurance Verification Review submission contact:  Stability Reimbursement Hotline, Tel: 855-925-615, Fax: 855-925-6544, Email:  reimbursement@stabilitybio.com.  By accepting (in accordance with Section 1 below) or using any Stability Biologics, LLC (“Stability”) Products, Customer agrees that the purchase of such Products is exclusively in accordance with these terms and conditions (“Agreement") and that Stability may enforce this Agreement against Customer to the fullest extent of the law. Stability expressly objects to and rejects any and all terms not set forth in the Agreement or that differ from the Agreement that may be proposed by Customer, whether contained in Customer’s purchase order or elsewhere, and no such terms shall have effect. Notwithstanding the above, if Stability and Customer have signed a separate, written agreement governing Customer’s purchase of Stability products, then the terms of that agreement shall govern in lieu of this Agreement. Stability Biologics, LLC full terms and conditions can be found at: https://www.stabilitybio.com/terms-and-conditions

Failure to obtain reimbursement for purchases does not release Customer from their obligation to pay for the product orders under this Agreement.  After thirty (30) days from the date that payment is due, any unpaid balance shall bear interest at the rate of 1.5% per month, or, the highest rate allowed by applicable law.  In addition, Customer shall be responsible for any and all costs actually incurred by Stability, including, without limitation, collections fees and reasonable attorneys’ fees and any other costs related to collecting any sums due to Stability.

 

1.     AVAILABILITY OF STABILITY REIMBURSEMENT HOTLINE.  Stability offers customers and potential customers access to a hotline where Stability will assist with completing insurance verifications for the coverage of AmnioCore, Amnio Tri-Core, Amnio Quad-Core, AmnioCore Pro and AmnioCore Pro+ products for any particular patient. This hotline is to help customers and prospective customers determine whether a Stability product may be right for a particular patient by helping to determine whether the patient will have applicable insurance coverage.  The purchase of Stability products is in no way contingent on the use of the reimbursement hotline.

2.    LIMITED WARRANTY.  However, Stability stands by the accuracy of our insurance verification process offered through the reimbursement hotline, such that Stability offers a limited warranty to customers who use and rely on the service in connection with product purchases.  Subject to the terms and conditions outlined below, Stability will provide a statement credit to customers for the value of the purchase price of the product that a third-party payor denied reimbursement for when the Stability reimbursement hotline had previously verified the insurance benefit for the specific patient and all other eligibility criteria for the Reimbursement Hotline Warranty program have been satisfied. 

3.    ELIGIBILITY.  In order to be eligible for the Stability Hotline Limited Warranty, a provider must follow the following steps:

 

a. Provider submits an Insurance Verification Review form to the Stability Reimbursement Hotline prior to commencing grafting with Stability Biologics products.  A form must be completed with true and accurate information such that the patient’s insurance eligibility can be accurately determined by the Reimbursement Hotline.

 

b. A provider must receive a positive affirmation from the Stability Reimbursement Hotline that the patient’s insurance covers a substantial (at least 80%) portion of the graft to be applied.   A positive affirmation must be sent by the Stability Reimbursement Hotline in order for the Limited Warranty to apply.

 

c. Coverage details and authorization requirements as outlined in the summary of patient benefits (provided by the Stability Reimbursement Hotline) must be followed by the Provider to remain eligible. 

 

d. The insurance claim must be submitted by the provider to the patient’s insurance with appropriate billing and coding requirements.

 

e. The Stability product must be used for the diagnosis provided on the insurance verification form and patient treatment must be in line with the Stability product package insert and / or instructions for use (included in each product package).

 

f. In the event that the patient’s insurance subsequently denies the insurance claim for the Stability product, the provider, working with the Stability reimbursement hotline, must submit at least one level of appeal to the patient’s insurance.  Based on the guidance of the reimbursement hotline, a second appeal may be required for the limited warranty program to still be in effect. The provider must submit all necessary information and documentation to the insurer to remain eligible for the limited warranty.

 

4.    VALUE PROVIDED.  In the event the process above is followed (as guided by the Reimbursement Hotline) and the patient’s insurance does not reimburse the provider for the Stability Biologics product, Stability Biologics, at its sole discretion, will provide replacement product or credit for the value of the product that was submitted to the Reimbursement Hotline.

The provider accepts that any replacement product or credit for product implanted in treatment of the patient treated with Stability Biologics products shall be fully and accurately reported as discount in accordance with the federal anti-kickback statute (42. U.S.C. SS 1001.952(h)) and to appropriately report such discounts to Medicare and Medicaid officials as required. 

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