Resources

On this page you will find important information regarding your appointment and resources you may find helpful.

 

Prior to Your Visit

CONTACT SHEET – Please print, fill out and bring to your first appointment or email to [email protected]

BILLING AND PAYMENT OPTIONS – Please read prior to placing your order or coming in for your appointment.

AETNA MEMBERS –  OUR CONTRACT & FEE SCHEDULE WAS UPDATED 7/15/24 TO INCLUDE MASTECTOMY PRODUCTS AND BILLABLE COMPRESSION GARMENTS.

LYMPHEDEMA TREATMENT ACT SUMMARY -CLICK TO READ DETAILS ON GUIDELINES

Insuance Coverage/Billing for Compression Garments – On 1/1/2024, CMS added 81 new procedure codes  for lymphedema products. However, the reimbursement that Medicare set for many of these codes was not what we had hoped it would be. Many of our commercial insurance and Medicare Advantage contracts do not include these codes and some plans either will not allow us to file a claim with these codes or will only reimburse based on a percentage of the Medicare fees. (For instance United Health Care discounts the Medicare price by 60%). We have worked dilligently with each commercial plan to attempt to have these codes added to our contract to be paid at a fair rate.

Effective 7/15/24, we have a new Aetna contract for most plans that includes compression garments. We continue to be an out of network provider with Carefirst BCBS – If you have out of network benefits, we will give you a copy of your doctor order and a detailed receipt for you to send in for reimbursement. We can bill most Cigna plans and  Johns Hopkins HealthCare plans for most compression garments. For Medicare patients, we can file your claim for compression garments. For some items, this will be a non-assigned claim meaning you pay upfront, we do the filing for Medicare to reimburse you. United Healthcare – to date we have been unable to add compression garments procedure codes to our contract and cannot accept reimbursement amount of 40% of Medicare rate and these plans will not allow us to do a non-assigned claim or you to submit your own claim. For all other plans, call or email us to get details about your coverage.

CLICK HERE FOR A MESSAGE FOR  OUR PATIENTS WITH CAREFIRST BCBS   OUR PREFERRED PROVIDER CONTRACT WITH CAREFIRST BCBS  EXPIRED ON 12/18/22. IF YOU HAVE CFT/BCBS, IT IS YOUR RESPONSIBILITY TO VERIFY YOUR OUT OF NETWORK BENEFITS AND SUBMIT YOUR CLAIM TO YOUR INSURANCE.

UNITED HEALTHCARE MEMBERS – WE ARE PREFERRED PROVIDERS FOR MOST AFTER BREAST SURGERY PRODUCTS. However, for compression garments, we are awaiting a reply to a request sent  to UHC to have these codes added to our contract. As of September 2024, we are still unable to bill these items to UHC until they add the codes to our contract to be paid at a fair market value.

LOWER EXTREMITY COMPRESSION GARMENT POLICY – Please read prior to your fitting for lower extremity compression garments

TELEHEALTH CONSENT FORM – Prior to a TELEHEALTH APPOINTMENT, you will need to fill out this form and email to [email protected]

COVID PROTOCOL – UPDATED NOV 2022 – Masks are optional at all of our locations, including the cancer centers. If you prefer we wear a mask for your fitting, please notify us beforehand.

Many of the items we carry are billable to your insurance and require a detailed written order with supporting documentation from your referring practitioner. You may request we fax this request to your referring provider or you may forward to your referring provider to have them complete and fax or email to us before your appointment.

Dispensing Orders: These forms are provided for your information:
Breast Products
Custom Breast Prosthesis
Wigs (Cranial Prosthesis)
Upper Extremity Compression Garments
Lower Extremity Compression Garments		 Medicare Supplier Standards
Privacy Policy

Before Your Wig Appointment                         Before Your Compression Garment Appointment

Return Policy: No returns or exchanges allowed unless item is defective and within manufacturers warranty time limits.

Payments: We accept cash, check and credit cards. We collect any out of pocket expenses (deductible, coinsurance, co-pay and non-assigned claims) at time of service. We do charge a 4% processing fee for credit and debit cards. We also offer CareCredit financing, subject to approval with minimum monthly payments.

Apply here to prequalify for CareCredit financing

After Your Visit

Instructions for Wig Care: