Medical Insurance Claim EDI Portal

Follow these 3-Steps to Ensure Your Insurance Claim Does Not Get Denied

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CALL your Insurance Provider and Ask the Following Questions!

  1. Ask if your policy coverage needs a “Prior Authorization” BEFORE a claim is submitted.
  2. The Medical Billing Code (CPT/HCPCS) for our wheelchair is K0813.
  3. Ask what their coverage amount will be according to your policy. Then you will know exactly how much you will need to pay out-of-pocket.
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GET A SCRIPT from your Medical Doctor. This script should have the following information:

  1. The Script should be written to cover a “Portable Electric Wheelchair“.
  2. Include all your Medical Diagnosis Codes (alphanumeric codes only).
  3. Include your Doctor’s Contact Information.
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FILL OUT the Insurance Claim Form below AFTER you have completed Steps 1 & 2!

  • We DO NOT hold partial claim information.
  • We DO NOT accept fax copies with your medical information.
  • Insurance companies process all claims electronically.
  • Your claim will NOT be submitted with partial information

MEDICAL INSURANCE CLAIMS CAN TAKE UP TO 6 MONTHS BEFORE YOU RECEIVE YOUR CHAIR

We DO NOT use Local Dealers or Third Parties to Handle Medical Insurance Claims - We Bill Direct!

FILL OUT THE MEDICAL INSURANCE FORM ONLY AFTER YOU COMPLETE STEPS 1 & 2

FILL OUT THE MEDICAL INSURANCE FORM BELOW