Home Phototherapy Insurance Reimbursement Program

Wouldn’t it be nice if someone else would take on the agonizing chore of dealing with your patient’s insurance company from start to finish?

Reduce the hassle by letting us do the work for you.

Daavlin has over 10 years of experience in insurance reimbursement assistance and getting payment towards home phototherapy equipment. Daavlin will assist you in getting pre-authorization and filing the insurance claim.

Simply submit the following information and your patient’s Patient Account Specialist will do all the work!

Download the following forms and please submit:

  • Completed “Home Phototherapy Patient Order Form”
  • Assignment of Benefits form in order to file the insurance claim
  • Copy of insurance card – enlarged, front and back
  • Prescription stating lamp type – NB UVB, BB UVB, or UVA
  • Letter of medical necessity (view/print samples)
  • Completed “Terms and Conditions of Sales Agreement”


Fax the information to 419-636-7916 or mail to Daavlin, PO Box 626, Bryan, OH 43506.

If you have any questions or require immediate assistance, email or call Daavlin at 1-800-322-8546.