Insurance
COVERED BY MOST INSURANCE
– Contact your insurance carrier for the appropriate
address to submit the “Insurance Invoice” and
“Certificate of Medical Necessity”. This paperwork
is in clinical terms required by insurance “Ostomy Support /
Barrier”, necessary for reimbursement.
Download
PDF Insurance Form here
MEDICAL INFORMATION –
For easy reimbursement from your insurance company we request
medical data from you in order to provide you with the appropriate
“Insurance Invoice” and a “Certificate of
Medical Necessity” that includes the following:
HCPCS Code: (It is imperative
to provide the following or the claim will be denied)
Description for DMERC EMC Record, HAO - Extra Narrative Record:
A4421 Ostomy Supply Miscellaneous
- OSTOMY Ostomy Support /
Barrier Protects the peristomal skin
integrity and prevents candidiasis. Supports the contents
of the pouching system which maintains the adhesive seal;
minimizing seal leaks - extending wear time of pouching system.
Download
PDF Insurance Form here
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