Insurance for Cranial Prosthesis in Seattle, WA

Insurance Coverage for Cranial Prothesis

We have found that only some insurance companies offer coverage for hair replacement prosthesis (wigs and hair pieces). Here is some information that may help you obtain coverage from your insurance company. At this time William Collier Design is unable to submit on your behalf, therefore claims are self-submittal; however, we will help you as much as possible. Contact us for assistance today.

 

  • Obtain a prescription from your physcian for a Full Cranial Prosthesis that includes a "diagnosis code". 
  • Gather as much information as possible to validate or support your claim. First obtain the name of the person within your insurance company who would be directly responsible for processing, and/or approving your claim.
  • Write a letter directly to the appropriate person explaining the details of your medically related hair loss. Also explain that a full cranial prosthesis was designed exclusively for you and was the only option available for leading a normal life.
  • Send a letter from each doctor who has treated you in connection with your hair loss. It is important that the doctor(s) describe the severity of the condition and explain that without the full cranial prosthesis, leading a normal life and being able to work would be difficult.
  • Send any pamphlets or articles on your type of hair loss with your letter. This could be important, if during the process they have any questions.
  • Send all of the above (Copy of the RX, information on your hair loss condition, a personal letter from you, letter from your doctor) along with your insurance claim form.

 

  • The most important thing to remember when submitting your claim is to be very thorough in your documentation. When the company reviews your claim, you want them to have the information needed to approve the claim in an expeditious manner. If their first answer is “no”, then ask to speak to a supervisor.  YOU MAY NEED TO ASK FOR AN “OUT-OF-NETWORK” EXCEPTION as there are no providers in Network in Washington State.
  • Below is the coding you will need to submit with your claim. Speak with your representative to verify the exact wording your insurer requires in order to reimburse you, as we have learned that each company is different. *Most often FULL CRANIAL PROSTHESIS is correct; though one company wanted it called a “WIG”.
  • WILLIAM COLLIER DESIGN                NPI #1063906295     (Our Tax-ID number is available upon request; our NPI # should equally work with any insurance claim submittals.)
  • PROCEDURAL CODE:  SERVICE/EQUIPMENT: E1399-DURABLE MEDICAL EQUIPMENT/MISC. 
  • Code Modifier A9282 Wig
  • DESCRIPTION:  FULL CRANIAL PROSTHESIS.  (An accurate description will be included on your computer-generated paid invoice.)    
  • Please note: Not all of the above will be necessary to submit a claim to your insurance provider. Most important are the bullet points in bold. We hope you find this information to be helpful.

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If you would like more information about how we can help, please call us to schedule a complimentary consultation