Physician Resources

Dear Physician Letters/Medicare

Dear Physician Therapeutic Shoes for Diabetics - Physician Documentation Requirements (pdf)

Download

Dear Physician Documentation of Artificial Limbs (pdf)

Download

Dear Physician Medical Records (pdf)

Download

Download Forms

Statement of Certifying Physician for Therapeutic Shoes (pdf)

Download

Documentation Requirement Fax requests used to request notes from physician.  These form may help identify what is required to determine medical necessity to ensure coverage for patients.

Spinal Orthoses (pdf)

Download

AFO-KAFO (pdf)

Download

Lower Limb Prosthesis (pdf)

Download

Upper Extremity Prosthesis (pdf)

Download

Knee Brace (pdf)

Download