Reimbursement Patient Data Sheet

The attached spreadsheet is for the patient to maintain all the information they need to be reimbursed. It is imperative that the patient has everything in order before they contact the insurance company for the pre-authorization. The more documentation you have, and the better it supports the procedure as reconstructive and medically necessary, and the only remaining option, the higher the probability you will be reimbursed.

It is very important that you know where all the documentation is, who has it and how it will be sent. For example, who will send the photographs and how? If you have multiple doctors I would get a letter from all of them. We have a sample template so they can use the verbiage that will help you get paid.

If you find some necessary information that is not on this spreadsheet please let me know and I will add it.

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