​

Follow these instructions to file an insurance claim for your wig / medical hair prosthesis.

Step 1: Get Pre-Approved

Download a sample estimate or contact us for a custom estimate at info@exquisitelabel.online Then ask your insurance provider how much they will reimburse you for your medical hair prosthesis, and how long it will take to get reimbursed.
 

Step 2: Purchase a Wig

Schedule a free consultation at our salon. We will listen to your hair loss concerns, and answer all your questions. Each wig is styled by our talented and compassionate wig stylists. Our goal is to help you look and feel like yourself again. Then when you are ready, you can purchase a wig. You don't have to leave your home or hospital.

Schedule consultation »

Step 3: File a Claim

Download and send Claim Form #1500 to your insurance company (contact your provider if the form is not listed below). Other items you will need include:

1. Federal Tax ID: #82-5383560

2. National Provider Identifier: NPI #: 1992002042, License #: 045279, NPI Registry

3. Common procedure codes: Synthetic (A9282, 99199), Human Wig (L8499)

4. Receipt: Paid in full as proof of payment

5. Rx: Diagnosis code from a doctor (for a medical or cranial hair prosthesis)

Claim Forms #1500: Aetna | Empire | United Health | Oxford | Emblem Health | Health First | Cigna