3

DQ= Z& U Z&)>!U ! Z mD^Q 88 > · Z& )> D "S ¼ ;p¼ ;|ʼ¼ ªÆ£Ú;ª¯;¯Æ ¼;Ó ª ¯¼À; Ô ¯;|pª;¹¼¯Ó ;p; À| ¼; #¯ªÆ¯¹ ¯¼ À À; Ó | ;J ; À| ¼;

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Page 1: DQ= Z& U Z&)>!U ! Z mD^Q 88 > · Z& )> D "S ¼ ;p¼ ;|ʼ¼ ªÆ£Ú;ª¯;¯Æ ¼;Ó ª ¯¼À; Ô ¯;|pª;¹¼¯Ó ;p; À| ¼; #¯ªÆ¯¹ ¯¼ À À; Ó | ;J ; À| ¼;

Ask just about anybody about one of the

most challenging things about

healthcare, and they'll probably say

"dealing with my insurance."

Communicating with insurance

providers and filing claims isn't fun, but it

doesn't have to be daunting!

Navigating the reimbursement maze on

behalf of patients is one of the things we

do best, which is why we've created this

guide to provide a roadmap to help.

W H Y

Y O U

N E E D

T H I S

Y O U ' L L N E E D

T H E S E T H I N G S

R A F I S C H E R C O .

I N SURANCE RE IMBURS EMENT GU I D E

A copy of your receipt/invoice

A letter of medical necessity

from your doctor

A copy of your original

prescription

You will need to contact your insurance company to

obtain a health insurance claim form or download a

copy from their website. Your claim form will also give

you additional instructions pertaining to what other

information they may need from your doctor or

healthcare facility.

G E T Y O U R

C L A I M F O R M

Page 2: DQ= Z& U Z&)>!U ! Z mD^Q 88 > · Z& )> D "S ¼ ;p¼ ;|ʼ¼ ªÆ£Ú;ª¯;¯Æ ¼;Ó ª ¯¼À; Ô ¯;|pª;¹¼¯Ó ;p; À| ¼; #¯ªÆ¯¹ ¯¼ À À; Ó | ;J ; À| ¼;

T H E I N F O

"There are currently no other vendors

who can provide a Fischer

Iontophoresis device. RA Fischer Co is

the manufacturer and sole dispenser

of this machine and dispense directly

to the patient. If you have any other

questions, please feel free to contact

us at (800) 525-3467."

0 1Provider Name:

A.R. Hinkel Co, Inc. dba R.A. Fischer Co.

0 2Provider Address:

25 W. Easy St. #301

Simi Valley, CA 93065

0 3Provider Phone:

1-800-525-3467

0 4NPI:

1174815484

0 5TAX ID:

95-4063106

0 6HCPCS:

E1399, A9900, A9999

A D D E D

N O T EIf your insurance claim form includes an

additional notes field, feel free to include

the following from RA Fischer Co.:

Your insurance  claim form will ask for the

following information:

0 7ICD-10 Diagnosis Codes:

L74.510 - Primary focal hyperhidrosis, axilla

L74.512 - Primary focal hyperhidrosis, palms

L74.513 - Primary focal hyperhidrosis, soles

FYI: If your insurance deductible is more

than the cost of our device, you can pay out

of pocket and apply the costs!

Page 3: DQ= Z& U Z&)>!U ! Z mD^Q 88 > · Z& )> D "S ¼ ;p¼ ;|ʼ¼ ªÆ£Ú;ª¯;¯Æ ¼;Ó ª ¯¼À; Ô ¯;|pª;¹¼¯Ó ;p; À| ¼; #¯ªÆ¯¹ ¯¼ À À; Ó | ;J ; À| ¼;

" I A M G R A T E F U L F O R Y O U R H E L P

A N D T H E M A C H I N E R E A L L Y

W O R K S . I W I S H E V E R Y O N E W I T H

T H I S C O N D I T I O N C A N G E T S O M E

R E L I E F A N D P E A C E O F M I N D . "

- AYEOLA

(PART OF OUR HAPPY-HIDROSIS FAMILY)

Share Your Story! @rafischerco