Letters of Medical Necessity

What is a letter of medical necessity?

A letter of medical necessity is a formal document provided by a licensed healthcare provider. It explains why a specific treatment, product, piece of medical equipment, medication, or medical service is essential for a patient’s health and well-being.

When may you need a letter of medical necessity?

LMNs are often required by insurance companies, government health programs, or tax-advantaged healthcare accounts when you’re seeking reimbursement for medical expenses that may not be automatically covered or considered eligible by the IRS.

How to get a letter of medical necessity

The process for obtaining an LMN may vary depending on your circumstances, but it typically looks like this:

  • Consult with your healthcare provider and share the patient’s condition, diagnosis and medical history.
  • Ask your healthcare provider to issue a letter of medical necessity for the equipment you’re seeking.
  • Check the letter for accuracy and completeness, making sure it aligns with your specific needs.
  • Review the guidelines of your insurance provider or healthcare administrator, and be sure the letter complies with specific requirements.
  • Submit the letter to the relevant entity for consideration. Include supporting documents if required.
  • Maintain a copy of the letter for your records in case you need to reference it for future medical expenses or insurance claims.

    • What’s in a letter of medical necessity?

    In a Letter of Medical Necessity for Durable Medical Equipment, it must be clear that a SleepSafe® Bed addresses the need for complex rehab or care. The letter must emphasize the clinical needs of the patient by the recommendations from medical doctors, Assistive Technology Professional s (ATP’s) and professional therapists.

    It must be explained on how the patient’s needs are not being met by their current bed and how a SleepSafe® Bed can be prescribed to meet the patient’s medical needs.

    We believe this step-by-step outline is helpful for writing a Letter of Necessity.

    A Basic Outline for a Letter of Necessity:

    1. Introduce the patient and how long they have been in the care of the doctor or facility. Describe their condition and how they are at risk: lack of control; no recognition of danger from falling out of bed; entanglement in tubular side rails; entrapment or suffocation due to the gaps around the mattress.

    2. Emphasize the clinical needs of the patient by the recommendations from medical doctors, Assistive Technology Professional s (ATP’s) and professional therapists.

    3. With the help of health care professionals, familiar with patient’s condition, recommend the bed model that addresses each of the patient’s medical needs. Denote specific requirements such as full safety rails, safety rail height required for safety, or the necessity of articulation to raise the head or knees for treatment.

    4. The imperative that the specific medical needs and complex care be addressed to prescribe the appropriate SleepSafe® Bed model and its functionality.

    We appreciate the opportunity to help find a way to work through the process. Please feel free to call Customer Support for further assistance at 866-852-2337 from 8 am to 5 pm EST.

    Sample Template for Letter of Medical Necessity for Durable Medical Equipment
    Sample Template

    *Visit the web to view “Hospital Bed System Dimensional & Assessment Guidance to Reduce Entrapment – Guidance for Industry and FDA Staff” (published 3/06)

    “Safe in Bed” Government agencies have long warned of the hazards of bed rails, but they are still used in many nursing homes. (New York Times article)

    SleepSafe® Beds patented design exceeds new safety guidelines by addressing entrapment issues.