Insurance Forms

Insurance Reimbursement Information

The Letter of Medical Necessity (LMN) is provided by our company at the time your order is placed and may be required by insurance to authorize payment for Durable Medical Equipment or other medical services. This form allows your doctor to provide everything your insurance company requires and includes our device’s billing code. 

You must submit the LMN, completed and signed by your doctor, along with your rental or purchase receipt to your insurance company.

Letter-of-Medical-Necessity (PDF DOWNLOAD)

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