Insurance Verification and Education Form
Download this form to give to your patients being treated with VNS Therapy. The Insurance Verification and Education Authorization Form should be completed by the psychiatrist with the patient's consent and then faxed to Cyberonics. At this point, a licensed nurse case manager will analyze the patient's insurance benefits to determine how the patient can access VNS Therapy through his or her insurance. The case manager provides billing codes and assists with insurance approval of coverage and reimbursement for the VNS Therapy system and procedure.

Upon completion, the form can be faxed to Cyberonics.
Fax: 888-577-7205

Download Insurance Verification and Education Authorization Form

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