Letter of medical necessity

Sample request

A letter of Medical Necessity or Justification tells what type of medical equipment is needed due to a verifiable medical condition or impairment. This letter is usually written by a physician, therapist, or an experienced rehabilitation technology supplier and is addressed to the third-party payer. For more information and examples of LMNs that explains to the third-party payer why the recommended medical equipment is important, please fill out the form below. 

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