PRIVATE INSURANCE INSTRUCTIONS OVERVIEW
1. About Private Insurance, HMO, PPO and Managed Care
The SOFTEE® is covered for medical reimbursement by many private insurance companies and Health Maintenance Organizations. Contact the benefits department of your carrier to clarify coverage, how much they will reimburse, and if you need prior authorization. The industry billing code number for the SOFTEE® is the same as for Medicare, #L8015. The medical item description is also the same "External breast prosthesis garment, with mastectomy form - post mastectomy". At your request, we will include a copy of the standard insurance claim form (#1500) inside your SOFTEE® shipment. You can also find that form here. Most insurance companies have a form that you can download. When contacting them you may ask them where to find the form that they require.
2. Steps to Receive Private Insurance Reimbursement
Note: If you are concerned about coverage and you want to be sure the items you are ordering will be covered, we recommend that you contact your insurance carrier prior to your purchase to determine if the SOFTEE® is indeed a covered benefit under your health plan and if you are required to pre-authorize. In some cases, your insurance carrier may not pay without prior authorization.
When submitting a bill for medical reimbursement you must include:
A pre-authorization number if applicable
The original invoice or receipt
A completed and signed standard medical reimbursement form (#1500 or the form given to you by your insurance company)
A prescription from your physician
Submit the original paperwork to your insurance company and always keep a copy of each item for your records
Note: If you have Regence Blue Cross/Blue Shield Insurance, you must download and fill out this form and mail it to the address listed on the form.
3. More Questions?
If you have questions or if you are unable to download and print the forms here, please contact our customer care department toll free at 1- 866-605-8585. Regular business hours are Monday through Friday 8:00am - 4:30pm Eastern Standard Time. We have insurance forms that we are happy to send to you upon request.