SMA Medical Supply has successfully submittetd claims to many private insurance companies on behalf of our customers. As an out-of-network provider, we require the following information from you before submitting your claim:
- A signed copy of our authorization/financial responsibility form
- A physician's prescription for the item/items being ordered
- A letter of medical necessity from your doctor (only if necessary)
- A scanned or faxed copy of your current insurance card (front and back)
- Your personal insurance information including the following:
- Patient full name, date of birth, gender, address, phone
- Patient's onset of symptoms/date of diagnosis
- Insured's full name, date of birth, gender, address, phone
- Insured's employer, insurance program name, ID and Group number from your card
- Claims address and provider assistance phone number from your card
We are pleased to assist with the pre-authorization process or pre-determination process. SMA Medical Supply is NOT a Medicaid approved provider. If your family utilizes government benefits, it may be in your best interest to select a different equipment provider that can submit these claims on your behalf.
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