Frequently Asked Questions

How can I determine if my insurance covers VNS Therapy?
To have your insurance benefits verified for VNS Therapy-related coverage, you can either speak with a Regional Case Manager (RCM) by calling 1-877-NOW-4VNS (1-877-669-4867) or ask your psychiatrist to complete an Insurance Verification form. This form is HIPAA compliant (protects patient privacy) and provides an RCM with your insurance information to facilitate insurance benefits verification. Your psychiatrist may initiate this verification process.

What does prior authorization mean?
In many instances, your insurer must authorize coverage of specific treatments, including VNS Therapy, before you can receive them. Your insurance company may need to review your medical history in order to agree with your psychiatrist that VNS Therapy is medically necessary for you. When a prior authorization is required, a Regional Case Manager can collect your clinical information from your psychiatrist and submit the necessary information to your insurer for you.

What is the average length of time it takes to obtain a decision in the prior authorization process?
It can vary from 2 months to much longer. The average expected length of time for a decision depends on whether a formal review is required, if additional treatments are required, and/or if a second opinion is required prior to a decision.

If an insurer denies VNS Therapy, what are the next steps?

• The Cyberonics Regional Case Manager may assist your psychiatrist and you in the appeal process. Each plan has an appeal process that may have multiple steps.
• Because each plan differs, it is recommended that you and your psychiatrist work with a Regional Case Manager to determine the most appropriate process for you.