We are Here to Help You Bill Your
Health Insurance for your Out-of-Pocket Equipment & Supplies
We are always glad to provide an invoice and other information so you may bill your
insurance carrier. This will not constitute the acceptance of
assignment or the acceptances of your insurance company's approval
amount as our payment amount. Any payment made to
SleepRestfully.com, at the time of sale constitutes the final
payment amount accepted by you the customer. You are required to
pay the full cash sale price of the equipment prior to
shipment. Any and all arrangements between a customer and
their 3rd party payors remains between those parties and is outside
of any transaction with SleepRestfully.com. You are
responsible for the total sale price charged.
To assist you in the completion of your insurance claim form
we are providing general instruction for the completion of this form along with
a downloadable and printable insurance claim form with information on Sleep
Restfull, Inc. prefilled. We can not guarentee that your insurance company
will accept your claim and the amount if any that you will be reimbursed. Please
contact your individual insurance company to asist in the determination of any
Items usually required by insurance company along with
- Invoice for the merchandise purchased.
- A copy of your prescription and/or letter of medical
Items which must be completed on you claim form:
- All patient information and health plan information.
- Signature of patient and date completed.
- Diagnosis code. This can usually be found on your prescription or sleep
study or you may contact your physician's nurse for this information.
- Name of physican and his NPI number. The NPI number is usually on
prescription or may be obtained from physicians office.
- HCPCS Codes. You will find the most common codes on our site under
"Insurance Billing Codes" or click HERE
If you have any questions concerning the cpmpletion of your claim form we
suggest you contact your insurance carrier prior to sending the form inorder to
avoid having to resubmit it.
Download Claim Form and Instructions with Sleep Restfully completed
information by clicking