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PATIENT AUTHORIZATION FORMS (For US Only)

Great news! Your physician has prescribed the Game Ready® System to fast-track your upcoming recovery from orthopedic surgery or injury. Game Ready is the injury treatment system of choice for thousands of prominent orthopedic clinics, athletic trainers, and physical therapy centers. Below, you’ll find the forms necessary to rent the Game Ready System, as well as resources in your community to aid in your recovery.

 
CoolSystems, Inc. (makers of Game Ready) is proud to be nationally accredited as a healthcare provider through the Community Health Accreditation Program (CHAP). CHAP is the leading independent, non-profit accrediting body committed to improving the quality of community-based healthcare services in the USA.

 

 

Describes the details of the system rental transaction and post-op knee brace purchase, covering what’s included, responsibilities, and insurance billing.

Patient Orientation Checklist: This is our way of ensuring that we’ve provided the necessary training, education, and forms for your use of the Game Ready System as a tool in your recovery.

  

Authorization and Release of Medical Information: Your insurance provider needs to review certain information to determine payment of your authorized benefits. By signing this form, you are allowing CoolSystems to share this information about you with your provider.

  

Notice of Privacy Practices: Describes how we collect, use and disclose the information you provide to us and your rights with respect to that information. Describes how medical information about you may be used and disclosed and how you can get access to this information.

 

Patient Bill of Rights: Describes your rights as a client of Game Ready and as a patient.

States that your decision to accept your physician’s recommendation to rent the Game Ready System is your own and that you are responsible for paying any portion of the fees that is not covered by your insurance provider.
Standardized notice that allows Medicare beneficiaries to make an informed decision about whether to rent and/or purchase Game Ready equipment and accept financial responsibility for fees if Medicare does not pay.
Standards that every Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) provider must meet in order to obtain and retain billing privileges.
Needed to process your rental and/or purchase, including payment and insurance reimbursement information.
Click here to obtain our Credit Card Authorization Form.
Provides additional information and support before and after your surgery or injury.

Common Questions

Click here for answers to frequently asked questions.