Get your Hair Back and look like you again
Get your Hair Back and look like you again
Insurance Reimbursement
Insurance Reimbursement
Tips on Filing your insurance claim
FILING A CLAIM FOR INSURANCE COVERAGE FOR A CRANIAL PROSTHESIS
1.Check your benefits covered expenses. Copy any page that specifically states coverage of prosthetic devices.
2. Obtain the name of the person at your insurance company who would be directly responsible for reviewing, processing or approving your claim form.
3.Complete your claim form
4.Take pictures of yourself without a hair prosthesis and without corrective eye makeup. This will immediately show that your claim is not for cosmetic purposes.
5. Detail the emotional effects of (medically related ) hair loss.
6. Ask your doctor for a letter on the importance of having hair on the job.
7. Write a letter directly to the appropriate person explaining the details of Chemotherapy, Alopecia, Radiation, Burns, or Surgery as it relates to your hair loss. Detail the emotional effects it has had on your life. Discuss the financial aspects of frequent wig purchases. Advise that cranial prosthesis is just as medically necessary as a prosthetic limb or breast it replaces a missing body part – HAIR!
8. Encloses brochures and pamphlets endorsed by the following support organizations. This is important if the insurance company has questions during the review process.
American Society for Dermatologic Surgery
5550 Meadow brook Drive Suite 120 Rolling Meadows, IL 60008
Phone: 847-956-0900
Fax: 847-956-0999
American Academy of Facial Plastic &reconstructive Surgery
310 Henry Street Alexandria , VA 22314
Phone: 703-299-9291
Fax: 703-299-8898
National Alopecia Areata Foundation
14 Mitchell Boulevard San Rafael, CA 94903
Phone: 415.472.3780
Fax: 415.472.5343
American Cancer Society
101 Ygnacio Valley Rd, Ste 110 Walnut Creek, California 94596
Phone: (925)-934-7640
The Burn Institute San Diego County
8825 Aero Drive, Suite 200 San Diego, CA 92123-2269
Phone: (858) 541-2277
Fax: (858) 541-7179
Send a case history of a person with the same or similar condition.
1 Send a detailed letter from each doctor who is treating you. It is important that the doctor describes the severity of the condition, extent of hair loss.
2. Explain that without a “Full custom cranial prosthesis “ leading a normal life and being able to work would be very difficult . He /She should mention the mental distress you have experienced due to your medical treatment.
3. A brief letter from psychiatrist or psychologist may also be beneficial if possible.
4. Enclose a prescription ( on actual prescription form) from the doctor who ordered the cranial prosthesis. The prescription must use this verbiage and have the correct diagnostic code for the insurance company to process your claim. A9282 ORN-1
5. Obtain a receipt from the hair replacement specialist performing the service. The invoice must show all charges and must be paid in full. Make sure receipt reads: “ A full cranial prosthesis to counteract the psychological distress secondary to ( alopecia, cancer, burns, radiation, injury, surgery etc.”)
6. Explain the differences between wigs and custom made cranial prosthesis.
7. Talk with your carrier by phone, insist they confirm your conversation in writing. If they fail to do so prepare your own record of the conversation.
The most important item to remember when submitting a claim is to be very thorough in your documentation. When the insurance company reviews your claim, you want them to have the information needed to approve the claim in an expeditious manner.
I hope this information has been helpful
Sincerely,
Michelle Martin
Hair Replacement Solutions for Women
1330 North Broadway Suite F ,Walnut Creek ,CA 94596
Phone: 925-287-1100
Website: hairreplacementsolutionsforwomen.com
Hair Replacement Solutions for Women