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Get Sample Letter Of Medical Necessity For Hoyer Lift

JECT: Insurance Coverage Request for EleCare or EleCare Jr (specify specific product) I am requesting insurance coverage and reimbursement of EleCare/EleCare Jr for my patient, The use of an amino acid-based formula such as EleCare/EleCare Jr is a key component of the medical management for this patient. Patient Information (to be completed by the physician) PATIENT S NAME DOB CURRENT WEIGHT CURRENT LENGTH/HEIGHT # OF MONTHS/YEARS UNDER MY CARE DIAGNOSI.

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