info@comfortcompression.com
(812) 303-3831

Fax: (866) 984-3831

(812) 303-3831

Refer a Patient

What We Need to Process a Referral:

  • Order details: what you want to order and measurements. If the provider is unsure, we’re glad to consult.
  • Patient demographics including insurance information. Copies of insurance cards are helpful but as long as the information is on the demo sheet we can usually proceed with verification. We need patient email if possible, or a phone number that can receive text messages.
  • Therapy notes: must include why the patient needs custom garments or accessories if ordering them. We can provide a list of common justification phrases.
  • MD Order: link our blank fillable order form here for download. We will follow up to get it signed if it’s not signed when we receive it. If the provider is using their own signed order form, it needs to be detailed (day/night, ready to wear/custom) with quantities.
  • For Medicare patients only: a note from the prescribing practitioner (MD, DO, NP, PA) establishing the patient’s lymphedema diagnosis. We cannot process Medicare orders without this. This can be an old note, office visit, hospital admission/discharge, etc. It must have a qualifying diagnosis but doesn’t need to be the main reason for the visit. Patients can also supply notes through MyChart or similar portals.

 

Qualifying Diagnoses:

  • Q82.0 — Hereditary lymphedema
  • I89.0 — Lymphedema, not elsewhere classified
  • I97.2 — Postmastectomy lymphedema syndrome
  • I97.89 — Other postprocedural complications and disorders of the circulatory system, not elsewhere classified

 

 

Therapy Note Justification Examples:

Include these example phrases so therapists know what documentation language we need:

 

  • “Patient has poor containment with Ready to Wear garment”
  • “Patient limb measurements do not fit into Ready to Wear Garment”
  • “Patient requires donning assist due to arthritis, weakness in hands”
  • “Patient requires donning assist due to inability to reach feet for donning”

 

 

How to Submit:

Download Prescription/Order Form

 

What Happens After You Refer:

Once we receive the referral, we will:

 

  1. Verify benefits and contact the patient to notify them of any out-of-pocket or upfront costs
  2. Send the patient consents
  3. Once the patient approves, we place the order and ship directly to the patient
  4. We notify the referring provider of any issues — insurance approval problems, difficulty reaching the patient, or backorder delays
Turnaround time is approximately 10-14 business days but can be delayed by backordered products or difficulty reaching the patient for consent/payment.

 

 

CMS Supplier Standards Notification:

The products and/or services provided to you by Comfort Compression, LLC are subject to the supplier standards contained in the Federal regulations shown at 42 Code of Federal Regulations Section 424.57(c). These standards concern business professional and operational matters (e.g. honoring warranties and hours of operation). The full text of these standards can be obtained at http://www.ecfr.gov. Upon request we will furnish you a written copy of the standards.