The Process For Patients
Physician Prescription Required
If you are a patient and you’d like to know if a pneumatic compression system would be the right product for you, please consult with your physician. It is important to note that in order to begin compression therapy, a prescription from your physician and authorization from your medical insurance provider will be required.
Garments:
Insurance requires that you must be treated annually for lymphedema if you want to use insurance to cover your products. If you do not have the required clinical documentation you will need to see your Lymphedema Therapist for them to provide your progress notes, choose the appropriate garments for you, and measure you for the correct sizing. Your therapist can then place your order via our portal at: https://www.parachutehealth.com/midwestcompression
If you do not have a therapist or the documentation insurance requires, you can purchase your products at https://www.midwestcompression.com/shop and submit for reimbursement yourself or use FSA or HSA funds. If you have been seen by a therapist in the past year and possess the documentation your insurance requires you can start your order and fax a current RX, your progress notes, and the products you would like. If they are complete, we will submit them for authorization with your insurance company and if approved will send you a secure payment link if your plan requires a co-pay.
Please fax: 800-886-4201
COLD COMPRESSION PRODUCTS (BIOCRYO) : NO PRESCRIPTION REQUIRED
We service the Midwest States.
Download our Compression Pump Referral Form here to bring to your provider to complete!
Document Center
Click The Document Name to Download
Compression Pump RX Form: PDF (Have provider complete form and fax to: 800-886-4201)
Compression Garment RX Form: PDF (Have provider complete form and fax to: 800-886-4201)
DVT Referral Form: PDF (Have Provider Complete and Fax To: 800-886-4201)
Compression Pump Intake Form: Standard or Fillable
Patient Consent Form: Standard or Fillable
Patient Assistance Form: Standard or Fillable
Patient Demographic Form: Standard or Fillable
Pump Measurement Forms:
Pump Sizing Charts:
Garment Forms: