Insurance company...possible reimbursement 4 light therapy device

Discussion in 'Fibromyalgia Main Forum' started by shinlee, Mar 11, 2006.

  1. shinlee

    shinlee New Member

    Hello all.

    This is the second bit of info in the last two days I have found regarding requests for insurance reimbursement for a supplement (Transfer Factor - see) and this one...a light therapy device for those dealing with depression/SAD.

    Below is a form letter that your doctor can submit to your insurance company on your behalf to cover the light therapy device.

    Hope this helps some of you.


    Requesting Insurance Coverage of the BioPure BP-12 Combo & Jr.

    Instructions: Many insurance companies will reimburse all or a portion of the cost of a light therapy device if proper diagnosis has been made by a qualified health professional. The following sample letter has been prepared to assist you in requesting reimbursement. It is to be prepared and signed by your doctor.


    To whom it may concern: (Insurance carrier)

    This is to certify that (your name) is a patient of mine. He/she is being treated for recurrent major depressions with a seasonal pattern.

    Referral to "seasonal patterns of depression" has been included in the most recent revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM IV). Phototherapy is no longer considered experimental, but is a mainstream type of psychiatric treatment for Seasonal Affective Disorder (SAD). According to the December 8, 1993 issue of The Journal of the American Medical Association (JAMA), "for many patients with SAD, light therapy should be regarded as a first-line treatment, given its high success and acceptance rate" (Vol. 270, No. 22, pages 2717-2720). In 1989, the American Psychiatric Association's Task Force on Treatment of Psychiatric Disorders (Vol. 3, pages 1890-1896, A.P.A. Press), recommended light therapy as treatment for the range of clinical depression diagnoses including:
    DSM IV-296.3X Major Depression, Recurrent
    DSM IV-296.4X Bipolar Disorder, most recent episode-Manic
    DSM IV-296.5X Bipolar Disorder, Depressed
    DSM IV-296.6X Bipolar Disorder, Mixed
    DSM IV-296.8 Bipolar Disorder, NOS
    DSM IV-296.90 Mood Disorder, NOS - Seasonal Affective Disorder
    DSM IV-311.00 Depressive Disorder, NOS

    In order to administer phototherapy adequately, a bright light unit is required. In (your name)'s case, the use of the bright light unit should be regarded as a medical necessity and may be used in conjunction with other forms of treatment.

    These procedures conform to April 1993 U.S. Public Health Service-Agency for Health Care Policy and Research guidelines for management of this disorder.
    AHCPR93-0551 Depress: Guideline Vol. 2
    AHCPR93-0553 Depress: Patient Guide


  2. justlooking

    justlooking New Member

    back to page one, hopefully this will help someone.
  3. cph13

    cph13 Member

    Hi everyone,<BR>
    I don't come on here very often. Since the site has changed I find it difficult finding what I need. My entire history is missing, search is usually inadequate etc. etc. etc. I am not complaining, just informing.<BR>
    With that said, I found a tad of information about bright light therapy and insurance. I am bumping this up to see if there is any more information out there<BR>
    JUSTLOOKING, Thank you for this. You were my savior today after hours and hours of reading. However, this goes back to 2006, certainly someone has more to add. I have been on this site all day researching, among other things, SAD.<BR>
    I am at my wites end. It so so bad this year. I would be willing to buy the bright light equipment but I would also like to hear from some of you if it has worked? Has medicare helped? ANYTHING! It's one of those times where U feel so alone U just want to scream. Loosing all of my contact buddies on here due to changes in the site, well, I'm sure most of you have been where I am. "POOR ME" Maybe this will help me make new contacts with all new good info.<BR>
    Blessing to all, ((((((((gentle hug)))))))))))) and pixie dust strewn on your heads 8-p<BR>
  4. cph13

    cph13 Member

    Thank you ever so much for this information. I'm trying to get an update to this post by bumping this. I realized I forgot to Thank you in that post.<BR>
    \Please accept my apology and my most Heartfelt thanks.<BR>
    Blessings, gentle hugs and pixie dust<BR>