Follow these steps to maximize the chances of having your insurance provider cover your cranial prosthesis:
Must complete Steps 1-3 before your virtual consultation:
Step 1: Obtain a Prescription
Ask your doctor (such as your oncologist or dermatologist) to provide a prescription for a
Cranial Prosthesis.
- Ensure the prescription includes the CPT Code A9282 and states that it is medically necessary.
- Example wording: “Cranial prosthesis (CPT Code A9282) prescribed for medical necessity due to [specific diagnosis: alopecia, chemotherapy, etc.].”
Step 2: Confirm Your Out-of-Network Coverage
Contact your health insurance provider to inquire about your out-of-network benefits.
- Ask if cranial prostheses (medical wigs) are covered under your plan.
- How much per year.
- Note any claim submission requirements, including forms, timelines, or additional documentation.
Step 3: Request a Letter of Medical Necessity (Optional)
Some insurance companies require a Letter of Medical Necessity from your doctor.
- The letter should explain why a cranial prosthesis is necessary due to your medical condition and how it supports your health and confidence during treatment.
Step 4: Purchase Your Cranial Prosthesis
Work with a certified provider (such as Glam Through It) to select and purchase your cranial prosthesis.
- Make sure to save all receipts and documentation.
Step 5: Obtain a Superbill
As your provider, we will provide a Superbill receipt after your purchase.
- This is an itemized receipt that includes:
- Provider’s information (name, address, and tax ID)
- Patient’s information
- Date of service
- Item description: Cranial Prosthesis
- CPT Code: A9282
- Total cost
Step 6: Submit an Insurance Claim
Complete the insurance claim form provided by your insurance company and attach the following:
- Superbill Receipt from your provider
- Doctor’s Prescription (with CPT Code A9282)
- Letter of Medical Necessity (if required by your insurance company)
Step 7: Follow Up
After submitting your claim, follow up with your insurance provider to ensure they’ve received all necessary documents.
- Be proactive and address any additional requests or questions promptly.