Sample Letter for Insurance Company

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 will assist you in requesting reimbursement.  After it has been revised to contain your information, it must be signed by your doctor.

Click here to download the letter as doccert.doc (Word97). The yellow highlighting shows where you must revise it for your own information:

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 1890-1986, A.P.A. Press), recommended light therapy as treatment for the range of clinical depression diagnoses, including:

Code NumberDiagnosis
DSM IV-296.3x   Major Depression, Recurrent
DSM IV-296.4xBipolar Disorder, most recent episode-Manic
DSM IV-296.5xBipolar Disorder, Depressed
DSM IV-296.6xBipolar Disorder, Mixed
DSM IV-296.70Bipolar Disorder, NOS
DSM IV-311.00Depressive Disorder, NOS

In the case of ________your name________, in order to administer phototherapy adequately, a bright light unit is required and the use of the bright light unit should be regarded as a medical necessity and preferable to 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.

Publication #Publication Title
AHCPR93-0551   Depress: Guideline Vol. 2
AHCPR93-0553Depress: Patient Guide

Sincerely,

Your doctor's signature____________
Your doctor's address, etc.________
Date_______________________________

 

Revised 7/95
The SunBox Company, Specialists In Natural Lighting Systems
19217 Orbit Drive
Gaithersburg, MD 20879
Phone:  (301) 869-5980
Fax:  (301) 977-2281
Toll-Free:  1-800-LITE-YOU (548-3968). Email:  sunbox@aol.com


Contact:  Lou Puls  lpuls@nyx.net
Copyright © 1995-2000 Museion Research Corporation
This page text-only: http://www.nyx.net/~lpuls/doccert.html

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