Orthotic Coverage with Pacific Blue Cross: Everything You Need to Know
Custom Foot Orthotics Claiming Checklist for Pacific Blue Cross Members
Ensure you provide the following when submitting a claim for custom-made foot orthotics:
- A completed Blue Cross claim form
- An original receipt indicating that payment has been made in full.
- A copy of the current prescription outlining the medical diagnosis from a physician, podiatrist, physiotherapist or chiropractor.
- A copy of your biomechanical assessment, which must be performed in person by your provider. (A biomechanical assessment is an examination of the lower limb bone alingment. It involves looking at the patient's movement and walking patterns, interaction of the foot with the rest of the body and shoes to determine wear patterns to assist in recovery of a recurrent injury or prevent further injury).
- Written confirmation from the person who made the product indicating that the orthotic was fabricated from raw material, using a 3-D voumetric model of the patient's foot, using one of the following casting techniques:
- Plaster of paris slipper cast
- Semi-weight bearing foam casting box
- 3-D contact digitizing (e.g. pin array system)
- 3-D laser imaging scanning