UNDERSTANDING THE COSTS ASSOCIATED WITH THE ZIO SYSTEM.

Your doctor has chosen the Zio system to determine if you are experiencing irregular heart rhythms.

HOW MUCH DOES THE ZIO SYSTEM COST?

Some healthcare providers will bill your insurance directly for the Zio system. In this case, you will not receive a bill from iRhythm and the information below does not apply to you. We recommend that you ask your healthcare provider if iRhythm will be sending a bill to you for the Zio system.

The Zio system is covered by health insurance plans for approximately 290 million patients in the United States. We recognize, however, that healthcare expenses add up and can be complicated. iRhythm is committed to ensuring that the Zio system is accessible to every patient for whom a physician believes the test is medically necessary. iRhythm Financial Counselors are available at 1-888-693-2401 to answer any questions you may have.

Please note that depending upon your insurance plan and healthcare provider, you may receive multiple bills for your Zio system: one bill from iRhythm and one or two bills from your doctor.

FOR MEDICARE PATIENTS

The Zio system is covered by traditional Medicare in all 50 states with most patients only owing a co-insurance. You do not need to contact your insurance provider or iRhythm when wearing the Zio monitor. Please note, Medicare Advantage patients should review the section below for patients with private insurance.

FOR PATIENTS WITH PRIVATE INSURANCE

Overview

Depending on your health insurance plan and benefits, you may owe a co-pay, co-insurance, or deductible. The amount you will owe is determined by your insurance company and can vary.

iRhythm will work with you on an individual basis to ease your financial burden. In order to benefit from these programs, please verify your benefits and coverage. Then select your preferred payment option before mailing back your Zio monitor and learn when to expect your bill.

For any questions about billing and reimbursement, please call an iRhythm Financial Counselor at 1-888-693-2401. There is no need to call your doctor’s office.

Verify your benefits and coverage

For details on your benefits and to obtain an estimate of your out-of-pocket costs, we highly recommend that you contact your insurance company directly. Please follow the steps below before mailing back your monitor.

  1. Find the customer service number on the back of your insurance card.
  2. Be ready to provide your name, date of birth, and member ID number.
  3. Follow the prompts for “Benefits” or “Coverage.”
  4. Inform the representative about the Zio system:
    • It’s a long-term ambulatory cardiac monitor which is a diagnostic test. It is not durable medical equipment.
    • It’s billed under procedure billing code CPT 0297T
    • The diagnostic test is performed by iRhythm Technologies, Inc. National Provider Identification (NPI) # is 1710130539.
  5. Ask the representative the following:
    • Is iRhythm Technologies considered in-network for my plan?
    • If not, how are out-of-network services reimbursed by my plan?
    • What are my out-of-pocket costs for this test?
    • Does my plan require preauthorization or predetermination from my doctor?
    • Does this require a referral from the prescribing physician or other physician?
    • (If you learn that your insurance plan considers iRhythm out of network) Can you make a coverage exception since my provider ordered the Zio monitor and iRhythm is the only provider that can perform this test?
  6. Request and record a reference number for your inquiry.

If you are concerned about the amount you may owe after speaking to your insurance company, we encourage you to call an iRhythm Financial Counselor at 1-888-693-2401. Please do so before mailing back your monitor.

Select your preferred payment option

iRhythm offers a number of financial assistance options tailored to your needs. The iRhythm Financial Counselors are available to discuss your payment options, including:

Option 1:

Have iRhythm submit the claim to your insurance company. Ask if you may qualify for financial assistance on a sliding fee scale based on your household income.

Option 2:

Choose to self-pay (a discounted price) instead of submitting the claim to your insurance company.

Monthly Payment Program

If you need to pay over time, interest-free monthly payment plans are available. All patients are eligible for this assistance.

When to expect your bill

An Explanation of Benefits (EOB) letter will arrive 3-6 weeks after mailing back your Zio monitor
If you choose to have iRhythm submit your claim to your insurance company, you will receive an EOB from your insurance company.

The EOB is not a bill. It is a statement from your health insurance company which explains how your claim was processed and any amount paid by the insurance company on your behalf. The amount you will owe iRhythm may change before the final bill is mailed to you. iRhythm will work on your behalf to ensure that your insurance company has processed the claim at the highest benefit level to minimize your out-of-pocket costs.

Your iRhythm bill will arrive 3 to 6 months after receiving your Explanation of Benefits
You will receive a bill from iRhythm after your insurance company has processed your claim and any appeals submitted by iRhythm on your behalf have been completed. Please note: a bill will only be sent for an open patient balance; if you owe $0, you will not receive a bill.

The amount you owe is determined by your insurance company based on your plan and benefits. This is the portion of the bill that your insurance company did not pay. Your patient share may be a co-pay, co-insurance, or deductible. Please follow the instructions on the bill to submit your payment via personal check, debit card or credit card.

If you receive a check from your health insurance provider
It is possible that your insurance company may send a payment directly to you instead of to iRhythm. If you receive a payment from your insurance company for the Zio system, it is your responsibility to pay iRhythm. Please send all payments to:

iRhythm Technologies, Inc.
Dept CH 19717
Palatine, IL 60055-9717

 

QUESTIONS?

For any questions about billing and reimbursement, please call an iRhythm Financial Counselor. There is no need to call your doctor's office.

iRhythm Financial Counselors
1-888-693-2401
6:30 am to 5:00 pm PST, Monday to Friday

CONSULT YOUR DOCTOR OR FIND A DOCTOR WHO PRESCRIBES ZIO