Carticel Care® FAQs
What is Carticel Care?
Will my insurance plan cover my CARTICEL implantation?
What is an EOB statement?
What kind of insurance support can I expect to receive from Carticel Care?
What role will Carticel Care play in the implantation scheduling process?
What happens to my biopsy after it’s taken?
How should I expect to feel immediately following implantation?
Will I need physical therapy following my implantation?
When will physical therapy begin?
What is a CPM machine?
Carticel Care is a resource designed with one purpose: to help you get going. From your biopsy to your rehabilitation, your Carticel Care Coordinator will explain procedures, provide insurance and scheduling support and answer any questions you may have. Speak with a Carticel Care Coordinator today at (800) 453-6948, Option #2.
Most insurance plans cover the cost of CARTICEL, but to be sure, check with your plan administrator or call (800) 453-6948, Option #2 to speak with a Carticel Care Coordinator. Your personalized Carticel Care Coordinator will work directly with your surgeon and insurance provider to speed your approval process and increase your likelihood of coverage.
After your implantation, you will receive an EOB (explanation of benefits) statement from your insurance company. It is not a bill and does not require payment. It’s simply a record that lists the medical services provided and an explanation of coverage for each service. We highly recommend you hold on to your EOBs in case you have questions or concerns regarding your insurance claims.
Key things to know about your EOB Statement:
- It is not a bill and does not require payment.
- It is a list of services provided to treat your medical condition.
- It simply explains what your insurance company paid for those services provided.
- There may be opportunities to increase your coverage.
- The Carticel Care® team will assist you with all your insurance questions.
Questions or concerns about benefits and coverage of your CARTICEL procedure can be directed to our insurance specialists at (800) 453-6948, Option #2.
In addition to explaining your insurance benefits and coverage, your Carticel Care Coordinator will interface directly with your health care insurance provider to assist with insurance claim processing, reimbursement and authorization.
CARTICEL is a customized product that requires careful calculations of the cell culturing time for each individual patient.
Your Carticel Care Coordinator will help to schedule cell culture and manufacturing based on the implantation date you and your surgeon request. After the process is set into motion, your coordinator will maintain ongoing communication with the manufacturing facility and your orthopaedic surgeon, coordinating schedules of all parties involved.
After your biopsy is taken, it is sent to Genzyme Biosurgery for processing. It then remains stored at our facility for up to two years or until you and your surgeon decide to go forward with the implantation procedure. When you're ready, your surgeon will schedule your CARTICEL implantation at your convenience.
As with many surgical procedures, you may experience pain and discomfort but medication can help to alleviate most of your symptoms.
Yes. Rehabilitation plays a major factor in the outcome of your CARTICEL implantation. Your doctor and physical therapist will design a program especially for you based on the size, location and severity of your cartilage injury.
Depending on your cartilage injury, rehabilitation can start within 6-24 hours of surgery beginning with a CPM (continuous passive motion) machine. Additional therapy is required and will vary from patient to patient.
The CPM (continuous passive motion) machine allows the knee to move without engaging muscles. During recovery, using a CPM machine creates an environment important for cell growth, reduces the likelihood of knee joint stiffness and is proven to improve patient outcomes.