Support

 
 
Contact Us
Addresses Phone and Fax Numbers E-mails
Office Address:
Atos Medical Inc.
2801 South Moorland Road
New Berlin, WI 53151-3743
Customer Support
1.800.217.0025
Customer Support and Technical Service
info.us@atosmedical.com
     
Invoice Payment Only:
Atos Medical Inc.
Dept CH 17589
Palatine, IL 60055-7589
TheraBite Hotline
1.877.458.ATOS (2867)
TheraBite Inquiries
therabite.us@atosmedical.com
     
  Office Fax
1.844.389.4918
Insurance Questions
info.us@atosmedical.com
 
Forms and Insurance Information
Atos Medical Inc. will file claims for durable medical equipment (DME) orders. For an insurance claim to be filed, the following needs to be completed and returned to our office:

• Front and back copies of all insurance cards
• Prescription Diagnosis Form (including frequency of replacement)
• Patient Insurance Information Form (PIIF)
• Patient Service Agreement (PSA)Form

The type of DME equipment ordered, laryngectomy supplies or jaw motion rehabilitation supplies, will determine which forms are to be completed.

• Laryngectomy Prescription Form
• Jaw Mobility Prescription Form

To maximize your benefits, please contact Atos Medical's Customer Support at 1.800.217.0025.
 
 
Health Insurance Portability and Accountability (HIPAA) Information
The notices below describes how medical/health information may be used/disclosed and how it can be accessed.

• HIPAA Notice of Privacy
HIPAA Acknowledgement of Receipt

 
Medicare Compliance Letter
An affirmative statement by the Medicare beneficiary instructing Atos Medical not to file a claim to Medicare on the beneficiary's behalf when purchasing durable medical equipment, L8509, indwelling voice prosthesis. The beneficiary does not desire a Medicare claim to be filed and therefore understands there is no further appeal for payment.

Medicare Compliance Form

 
Medicare Provider Enrollment, Chain of Ownership System (PECOS)
For any durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) items to qualify for coverage by Medicare it must be ordered by a physician or a practitioner who is eligible to order such item.

PECOS Letter

 
For Additional information on Forms and Insurance Information, click here.