Reimbursement Support

Get assistance here to support an eXciteOSA reimbursement submission in the US.

Welcome

The resources below are designed to support reimbursement from your patient’s health insurance plan.

Our goal is to provide you with comprehensive resources to best navigate the process, including:  HCPCS codes, medical necessity and appeal templates. We acknowledge that every reimbursement case is different, and we are here to help.

In the background, our team is working toward gaining formal reimbursement. Since eXciteOSA is a novel therapy with no established national coverage guidelines, we are pursuing a dedicated code and appropriate coverage.

What you can do today

Use the resources below to start, track and complete the process.

Need help? Please contact us.

 

You can reach a trained specialist at reimbursement@signifiermedical.com

Or, call us at 844-MILDOSA and we’ll connect you to the right person.

Commercial Payer Patients

Here you’ll find a complete set of resources dedicated to eXciteOSA® submissions to Commercial Payers.

 

View Downloads

Medicare Patients

Please use these templated materials and letters of medical necessity and appeals for Medicare

 

View Downloads

Medicaid Patients

Please use these templated materials and letters of medical necessity and appeals for Medicaid

 

View Downloads

Commercial Documentation Checklist for DME suppliers and physicians

Download

Letter of Medical Necessity

Download

eXciteOSA Prior Authorization Appeal 1st

Download

eXciteOSA Post Claim Denial Appeal Letter

Download

PDAC DMECS Listing

Download

PDAC Award Letter 07-03-2021

Download

Payer Summary Reference

Download

Manufacturer’s Suggested Retail

Download

Letter of Medical Necessity for eXciteOSA®

Download

Medicare Documentation Checklist for Physicians

Download

Medicare Documentation Checklist for DME suppliers

Download

Payer Summary Reference

Download

Manufacturer’s Suggested Retail

Download

eXciteOSA Post Claim Denial Appeal Letter

Download

PDAC DMECS Listing

Download

PDAC Award Letter 07-03-2021

Download

Letter of Medical Necessity for eXciteOSA®

Download

Payer Summary Reference

Download

Manufacturer’s Suggested Retail

Download

2021_6 eXcite_LoMN

Download

eXciteOSA Prior Authorization Appeal 1st

Download

eXciteOSA Post Claim Denial Appeal Letter

Download

PDAC DMECS Listing

Download

PDAC Award Letter 07-03-2021

Download

Letter of Medical Necessity for eXciteOSA®

Download