Getting Started with Insurance Reimbursement

Insurance Claim Instructions

At MyEyes, we provide you everything we can to submit a claim to your insurance company.  Here are a few things to remember, and some tips on completing the process:

• Not all insurance companies will reimburse for a home tonometer.  We are finding more who will, but there are no specific companies who pay every time. Medicare will not pay for a home tonometer at this time, but some Medicare Advantage plans will.
• Call your insurance company and tell them you have rented or purchased a durable medical device with a prescription written by your doctor.  It sometimes depends on the representative you speak with when you call.  If they deny your request when you call, try calling back to speak with another representative, it helps to be persistent.
• There is no HCPCS (medical device) code for a home tonometer.  We recommend using code E1399 (see sample HCFA form) for “miscellaneous medical device.” The modifiers for the E1399 code are: NU for a purchased device, RR for a rental device.
• Some insurance companies may require additional information, such as your diagnosis code or a letter of medical necessity.  You should request this information from your healthcare provider.
• Submission of claim information is not the same for all insurance companies;  some require online upload, paper copies, fax, or other means of receipt.  Some companies have their own form or additional forms to complete.  Be sure to ask when you call.

Select Your Provider

To submit a basic claim to your insurance company, you will need:

1. A copy of your prescription (this was emailed to you)
2. A copy of your receipt from MyEyes (this was emailed to you)
3. A cover letter
   • Microsoft Word Template
   • Google Doc Template
4. A Health Insurance Claim Form (HCFA form)
   • Download Blank HCFA Form
   • Download Sample HCFA Form

Important Files Mentioned in this Article: