Qualifying Criteria
Thank you for viewing and downloading our qualifying criteria forms! There are two items Insurance companies
require for coverage consideration:
- Standard Written Order (SWO) - A standard form with detailed information
- Medical Records - Specific information that is needed in a patient's medical records
The SWO and Medical Records outlined below have Medicare requirements - some insurance companies may request
more. There may also be deductible and/or co-insurance requirements that will affect payment and customers may
always waive their insurance benefits and privately pay.
If you would like more information or if you would like us to prepare patient specific forms please contact us
at 651-644-9770.