31st October 2025
Our certified prosthetists helped more people access advanced bionic arms by overturning insurance denials with approval rates 30% higher than national averages.
When an adult upper-limb patient in Austin, Texas was denied coverage for a Hero PRO Open Bionics clinician Travis Heins, CPO, refused to give up.
“I used AI to digest some 100-pages of insurance policies to find the language that specifically refutes the denial,” Travis said. “Clinicians at other companies might not have the bandwidth or persistence to fight for patients like that, but at Open Bionics, we don’t take no for an answer. If there’s a way to get my patient a Hero PRO or RGD, some of the most advanced multi-articulating myoelectric prosthetic devices available, I’ll find it.”
Before taking the three-time denied insurance case to independent review, Travis was able to identify the exact coverage criteria, then gathered the most current research on multi-grip myoelectric devices.
Using an AI tool is only one aspect of Open Bionics’ unique approach. “I like to have a personal connection with my patients so I can best understand exactly what they need, and what they hope to do with their bionic arm,” Travis said. “The more trust we can build during the initial consultation, the better the outcome.”
By taking the time to listen to his patients, Travis was able to carefully map their goals to the insurance policy’s exact criteria, update the clinical notes, and submit a laser-focused appeal the same day. The result: An insurance approval.
“Too many people just think insurance won’t cover a bionic arm, but a lot of policies still reference pre-2020 research,” explained Elise Dreiling, CPO, Director of Clinical Operations at Open Bionics’ Lakewood, Colorado clinic. “We respond to denials with current, peer-reviewed studies specific to multi-grip myoelectrics, and this year we’re seeing about a 50 percent approval rate on appealed denials. That includes cases where policies had no formal appeal process or even an exclusion.”
[Check out our blog that outlines the latest in 3D printed prosthetic insurance claims ]
According to a 2023 report, about 19 percent of in-network claims from federal Health Insurance Marketplace plans were denied. Out-of-network claims were denied at about 37 percent, and less than 1 percent of denied claims were ever appealed, meaning most people simply gave up without realizing an appeal could succeed. Assisting with insurance appeals is just one way Open Bionics clinics make a difference in people’s lives.
Travis shared how even a definitive insurance denial is not the end of the journey. For one of his patients, he is helping launch a crowdfunding campaign through the Open Bionics Foundation, a nonprofit founded in 2019 in direct response to healthcare systems being unable to provide advanced technology to those who need it most.
By combining human-centered care with advanced technology, our clinicians are redefining patient care and advocacy. “When someone is able to accomplish a goal with a new bionic arm, it changes everything” Travis said. “That is what keeps me doing this work.”
Even if you have been told your insurance will not cover a bionic arm, you might still qualify. Don’t let an insurance denial stop you from achieving your goals. Book a free consultation with an upper-limb clinician who won’t give up on you.
English 
USA 
German