Reach Medical, Inc. is a wholesaler only and not a Medicare Provider. Reach Medical, Inc. does not bill Medicare or Private Insurance. As a service, we will assist you in finding a Medicare provider if you have a Physician's order.

You may print a Physician Orders Form provided by Reach MedCare, LLC, an  independent provider, below by clicking on the Medicare Form link below. Or you may call us toll free at 866-496-7359 for assistance or to request information by mail. Reach MedCare, LLC. will proved the Elite Custom Manual or Elite Custom Battery device at the retail price of $475.00.
* Prices are subject to change without notice.

All information must be complete to process the order.

MEDICARE FORM

Steps in using Medicare Form

1. Download form

2. Take form and discuss with your Physician to complete order

3. Fill out all patient information & sign billing authorization

4. Your HIPPA, Bill of Rights, Notification of Privacy Rights
   & CMS Medicare Supplier Standards will be sent with product

5. Include copies of insurance cards (front & back)

6. Make a copy of your order form for your records

7. Mail Order Form and insurance card copies to Reach MedCare, LLC

8. Your Device will be shipped discreetly to your home

Call Reach Medical, Inc if you need assistance

866.496.7359

Reach MedCare, LLC
P.O. Box 1434
Collierville, TN 38027-1434