Tips for Insurance Submission
Many of our customers have successfully submitted claims for Custom Orthotics with their Extended Health Benefits and/or using their Health Spending Accounts (HSA). As each plan is different, we encourage you to check with your provider for details on your plan and instructions for submitting a claim.
Most policies require a Prescription from your Physician prior to placing your order. Orthotics Direct does not provide a prescription.
Some insurance policies require that the orthotic device be physically dispensed by a healthcare practitioner. Orthotics Direct provides a direct to consumer online shopping experience which does not include a dispensing process.
If you wish to contact your Insurance provider prior to placing your order to determine if your orthotic purchase is eligible for coverage, please complete the form at the bottom of this page and we will forward you a Sample Invoice as well as a Sample Proof of Manufacture & Biomechanical Report. These documents can be sent to your provider for a Predetermination.
We offer Predetermination forms for orthotics only. If you wish to predetermine your eligibility for footwear coverage, we recommend that you contact your provider with the brand and style details of your footwear selection. Insurance policies differ from plan to plan and some even cover certain models of shoes differently.
Ordering for Multiple People:
We would like to ensure that you have the best possible experience with Orthotics Direct and the subsequent submittal for reimbursement.
If you are ordering for yourself, as well as for another individual and are seeking reimbursement, we would recommend that the orders be placed separately. Each order will then receive its own separate Invoice and related documentation, which is often a requirement of insurance coverage.
If you place a single order for multiple claimants, all documentation will be in the name of the person who placed the order. Please be aware, you may then encounter problems when you submit to Insurance. It is always recommended that you contact your insurance company for details specific to your plan.
Please ensure that all names are submitted correctly as documentation cannot be changed after the order has been placed.
Some policies include coverage for footwear in addition to orthotic coverage. Many insurers use different terms for footwear. All footwear sold by Orthotics Direct is off the shelf footwear to accommodate orthotics.
If you are submitting the footwear portion, ensure the footwear is submitted as a separate item and not included in the price of the Orthotics.
The following documents will be included with every completed Orthotics Direct order:
- Invoice showing products purchased, date of purchase and payment in full.
- Proof of Manufacture and Biomechanical Report derived from assessment of your foot cast.
Once you have received your order, submit these documents along with your Doctor’s Prescription to your Insurance Provider.
Ultimately, your insurance provider will have definitive answers about your coverage and how to place a claim. If you have any questions, our team is also here to help.
Thank you for choosing Orthotics Direct!
Please complete the following form to receive Sample Documents, which can be sent to your Third Party Provider for Predetermination Eligibility. Once you have submitted the Predetermination Request Form, you will receive the document within the hour.
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