Claims Adjustors - fill in and/or choose what is correct. We will analyze the patient's diagnosis, device indications for use and insurance coverage, then reply ASAP. Or, simply choose what's appropriate.

So please fill in your E-mail address (or name and number) below.

Or, simply fax patient's face sheet to 800-682-4077 (in Miami 305-895-9095).

Alternatively, please us with diagnosis, treatments applied (their relative success), and type of insurance and we will respond with options available.

Please - Utilize Form:

Your E-Mail address here

Please provide your patient's diagnosis/prognosis w/ notes and/or any comments below:

What type (s) of treatments have already been utilized? Click on initials for device information and/or choose by clicking box at right of description:

	MANS - Muscle and/or Peripheral Nerve Stimulation
	EDA - Electronic Dental/Medical Anesthesia
	CLP - Calibrated ( gradient,sequential ) Lymph Pumps
	CPM - Continuous Passive Motion (all joints)
	HVPG - High Volt Pulsed Galvanic
	LVG - Low Volt Galvanic
	EMG - Electromyography
	EMS - Electrical Muscle Stimulator
	BGS - Bone Growth Stimulator
	FES - Functional Electrical Stimulation
	IFS - Interferential Stimulation
	MENS - Microcurrent Electrical Stimulation
	TENS - Transcutaneous Electrical Nerve Stimulation
	All Stimulator Electrodes and Leadwires, Cryo-Therapy, Dynasplints, Nebulizers, Wound Care, Diabetic Supplies, Respiratory Care and all accessories...

Were treatments (if any) successful? Please elaborate:

What type of insurance does the patient have?:

Thank you for utilizing our 20 years of DME experience!