The Process for Physicians

If you have identified a patient that has a condition that could benefit from the use of a Compression Therapy System (Lymphedema, Venous Insufficiency) :

Our preferred method is to place orders through the Parachute Health platform. This eliminates faxing, emailing and phone time and helps patients get garments quicker. 

Sign up: https://www.parachutehealth.com/midwestcompression 

  • Create Log in

  • Sign in with username and password

  • Pin Midwest Compression  

  • Place orders for compression pumps and garments

Contact us if you have any questions.

  1. You will need to write a prescription for a pneumatic compression pump to treat the appropriate condition. The prescription must identify the area of the body to be treated, (ex. Bilateral Legs, Right Leg, Left Leg, Right Arm, Left Arm), how many times per day the pump is to be used, and length of each treatment cycle. You can also use the RX below.

  2. You must provide the patient's demographic information, including the patient's insurance and a copy of the diagnosis and signed progress notes outlining the provider's recommendation for compression pump therapy.

  3. Fax the prescription to Midwest Compression at 800-886-4201, at which point Midwest Compression will seek to obtain authorization from the patient's medical insurance provider (if necessary).

  4. Once authorization is obtained (wherever applicable), Midwest Compression will contact the patient directly to set up an in-home appointment to fit, set up, and educate the patient on how to use that pump. The trained installer will test the pressures for the patient and ensure patient is comfortable with the pump.

  5. Midwest Compression will send a delivery confirmation for the medical record.

FAX: 800-886-4201

Click the links below to view Compression Pump Referral Instructions and download the Midwest Compression Pump RX Forms

Compression Pump Referral Instructions

Compression Pump RX Forms: PDF

LMN

Conservative Trial Form

(Have provider complete form and fax to: 800-886-4201)

Compression Garment RX Forms

Compression Garments Referral Instructions

Compression Garments RX Forms:

Lower RX

Upper RX

(Have provider complete form and fax to: 800-886-4201)

Click the links below to view DVT Pump Referral Instructions and DVT Referral Form.

(FAX TO: 800-886-4201)

DVT Pump Referral Form

DVT Pump Instructions

(Have provider complete form and fax to: 800-886-4201)

For other patient documents/forms please visit our document center below

Document Center