Referring a patient to one of our physical locations

We are excited to service and care for your patient’s needs. To make sure they receive the correct recommended product and to bill their insurance, we need a signed physician order. On the prescription please include patient name, date of birth, ICD-10 diagnosis, products prescribed, signature and date prescribed.

If you would like to see or use one of our prescription forms please use the links below.

Compression Rx

Mastectomy Rx

Guide to recommended compression
level for diagnosis

Appointments are not required but are recommended. We want to ensure we dedicate the appropriate time to properly fit and answer all your patients’ needs. We also recommend they call ahead with their insurance information so we may verify coverage prior to their appointment.

If you have any further questions, need brochures or would like an in-office meeting regarding our services please call or email us.

CONTACT US

Referring a patient online

We understand that knowing patient’s coverage ahead of time helps you plan and decide the home care plan once you discharge your patient. We recommend faxing us your patient’s insurance information at the beginning of treatment. We will then fax you the patient’s coverage and let you know if pre-authorization is required before we can order the products.

Pre-authorizations average 7 to 10 business days with most insurance companies.

To get started, please print, fill out and fax the pages below to 512-986-6330.

Verification of Benefits

PDF

Complete the following forms when you are ready to order the desired product for your patient.

Medical records release

Exchange Policy

Product measurement form

Verification of Benefits

Practitioner FAQ’s and questions

Terms and Conditions

Prior to ordering your patient’s products we verify coverage and inform you of what and how many garments they will cover. We will also inform the patient if and how much of an out of pocket expense they will have for the specific item.

How long will it take for my patient to receive their garment?

Standard off the shelf products take approximately 3-5 days to receive given that all required paperwork is received to order the items. Custom garments take approximately 10-14 days to produce and ship. Expedited shipping and production may be available at an additional expense.

*If your patient’s insurance requires prior authorization, this will take up to an additional 7 business days

What happens if my patient’s products do not fit?

All custom made products have a two week remake policy. They are not returnable, but we ensure the fit. Off the shelf products vary by manufacturer. Due to the nature of the products there are certain items that cannot be returned or exchanged. Please see each individual manufacturer’s exchange policy as it may apply to you.