Be prepared: Ask you doctor to write a prescription for your Functional Formularies product. Bring to your doctor’s visit: a sample referral form and letter of medical necessity.
Research: Find a DME that takes your insurance and carries Functional Formularies products.
Make the call: Ask the insurance company what they need for coverage.
If denied: Request a written letter from the insurance company.
We are here to help: We have patient advocates available to help assist you in gaining insurance coverage for our products. Please contact us.
We have an insurance specialist on staff, free of charge, to help with the insurance and Medicare/Medicaid approval process. We are the first organic enteral formula to be approved by Medicare. The Medicare billing code for Liquid Hope and Nourish is: B4149—Blenderized Natural Foods with Intact Nutrients.
Letters of Medical Necessity.
Recent progress notes (within six months) from your doctor.
A nutrition assessment treatment plan for Functional Formularies products from a registered dietitian, nutritionist, or a physician.
Referral form completed by your doctor, nurse practitioner, or physician assistant. This is NOT considered a prescription. (print from insurance page and give it to your doctor).
Copies of patient insurance cards, front and back.