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- I have lymphedema in my right breast and in my back. My lymphedema therapist says I need to get a Compressure Comfort Bra by Bellisse. There is a medical supply store in my town that told me that they are willing to measure and order it for me but I’d like to try one on first! Where can I go?
- My patient is wide waisted but small busted – how could I adjust the needed compression to best fit her body shape?
- Can I get insurance coverage for the Compressure Comfort Bra?
- I’ve had a mastectomy. What kind of prosthesis can I use with the Compressure Comfort Bra?
- I am a patient and my insurance company told me that they wouldn’t cover a compression bra for my breast lymphedema but they covered a compression sleeve for my arm lymphedema – why is that?
- I am a Bellisse Dealer and my company has received an insurance rejection from our claim for your product. What can I do?
- I’m a Bellisse dealer. How can I help my customers receive insurance reimbursements for the Bellisse® Compressure Comfort® Bra?
I have lymphedema in my right breast and in my back. My lymphedema therapist says I need to get a Compressure Comfort Bra by Bellisse. There is a medical supply store in my town that told me that they are willing to measure and order it for me but I’d like to try one on first! Where can I go?
You can get the Bellisse Compressure Comfort® Bra from many different types of dealers. But these dealers are not the same: they offer many different levels of service. We feel that the best dealers to choose are those that carry some Bellisse product on site, like Bellisse Preferred Dealers, which have a special Bellisse Fit Kit in their stores. The Fit Kit contains a core sample of our various bra sizes so that you can get the right fit the first time.
You can find Bellisse Preferred Dealers by checking our dealer locator. Preferred Dealers are indicated by the purple butterfly symbol. If you don't have a Bellisse Preferred Dealer in your area, please call us 1-877-273-1683 or email us at info@bellisse.com so that we can help you encourage a local dealer to become a Preferred Dealer. Or call your local medical supplier and ask them to become a Bellisse Preferred Dealer today!
PS: If you can, choose a dealer that can not only fit the Bellisse Compressure Comfort® Bra for you but also submit a claim to your insurance company for you!
My patient is wide waisted but small busted – how could I adjust the needed compression to best fit her body shape?
One of the best features of the Compressure Comfort® Bra is the “variable track option”. This is a three-level system of hooks and eyes on the back of the bra that lets you adjust size and compression precisely. For example, if more compression is wanted around the breasts but less beneath the ribcage, you simply use the tighter, inner track of hooks around the breasts, and the looser outer track at the bottom. But don’t worry – your patient doesn’t have to reach around her back to fiddle with the hooks and eyes. Just set the hooks the way she wants them before she put on the bra; she can then use the front zipper to close the bra after she puts it on.
Can I get insurance coverage for the Compressure Comfort Bra?
You sure can! Most insurers are now covering it. To help women obtain coverage, the Bellisse website provides comprehensive insurance information, including a discussion of the Women’s Health and Cancer Rights Act (which mandates insurance coverage of breast-cancer- related complications,), a sample letter of medical necessity, and the applicable insurance codes.
I’ve had a mastectomy. What kind of prosthesis can I use with the Compressure Comfort Bra?
With the Compressure Comfort® Bra, you can decide whether you want to wear a prosthesis or not. The soft cups of the bra are designed to mold to breast tissue and accommodate different breast sizes and shapes, so a prosthesis is not necessary for the bra to fit or be comfortable. But if you want to wear prosthesis or a breast enhancer with the Compressure Comfort® Bra, your bra fitter will be able to recommend one that will give you the silhouette you’re looking for.
I am a patient and my insurance company told me that they wouldn’t cover a compression bra for my breast lymphedema but they covered a compression sleeve for my arm lymphedema – why is that?
Some insurance companies say they won’t cover a compression garment partly due to the lack of good information or understanding that they have about truncal/breast lymphedema. It may be they don’t understand that your breast or truncal lymphedema needs compression just as much as your arm lymphedema does. Many are ignorant about the fact that lymphedema doesn’t stop at the shoulders.
We encourage patients to educate their doctors and insurers about truncal lymphedema. Our site at www.bellisse.com can help you do that.
We also suggest that you purchase your Bellisse Compressure Comfort bra from a medical supplier who will submit an insurance claim on your behalf. These suppliers often hold contracts with local insurers and ”know the ropes” best. They should understand which code to use and what paperwork (i.e.. a doctor’s prescription, etc.) needs to be sent for best reimbursement results. Bellisse dealers all over the United States are reporting excellent insurance reimbursement results for the Bellisse® Compressure Comfort® Bra – similar or even better reimbursement results than for compression garments for the limbs. So please don’t take ‘NO’ for an answer!
IF you formally submit your claim and are rejected, we strongly encourage you or your medical supplier to appeal that rejection. Below is a link to a very helpful sample letter for patients whose insurance companies have refused to give them reimbursement/coverage for compression bandages or garments. Be sure to read the letter carefully and fill in the blanks as necessary, customizing it to your specific situation. Have your physician sign and send it, retaining a copy for your records.
http://www.lymphnet.org/lymphedemaFAQs/insuranceIssues.htm
Remember that the law is on your side: According to the Women's Health and Cancer Rights Act of 1998, breast cancer survivors may not be denied insurance coverage for medical care and devices needed to manage post-cancer side effects, including lymphedema. For more info, visit the Bellisse website at http://www.bellisse.com/pdf/cancer-rights- act.pdf, or go to the US Department of Labor Employee Benefits Security Administration website: http://www.dol.gov/ebsa/publications/whcra.html
Also remember that Patients Have Power! At Bellisse, we always encourage patients to help in the fight to gain insurance recognition. A patient can contact her insurance company herself or ask her human resources department at work to do so. If a claim is rejected, a patient should lodge a complaint about being denied coverage as a breast cancer survivor for products that are medically necessary. An insurer may not want to “rock the boat” over the denial and may well go ahead and approve the claim when challenged. Making some gentle “noise” (provided all the supporting paperwork is filed correctly) is usually quite helpful and effective!
I am a Bellisse Dealer and my company has received an insurance rejection from our claim for your product. What can I do?
We at Bellisse recommend that you don’t take ‘NO’ for an answer! We encourage you to be a “Claims Champion” for Your Truncal Lymphedema Patients. The good news is that we have developed some techniques for preventing insurance claim rejections from occurring in the first place, and we have several useful suggestions for women who are denied coverage.
The key to successful insurance reimbursement, for current lymphedema sufferers and those who will follow, is to be PERSISTENT AND CONSISTENT. If you or your customers are denied coverage, please don’t take no for an answer. Together we all can make a difference in the quality of life for the women suffering from Truncal Lymphedema!
The most successful formula is simple. Just be sure to always submit the following with each claim:
- A doctor’s prescription
- A letter of medical necessity, and
- An appropriate Miscellaneous Lymphedema insurance code (NOT a mastectomy code such as L-8000, which doesn’t work).
That’s it!
Bellisse has conveniently provided all these tools (codes, sample letter of necessity, etc) on our website, www.bellisse.com. They’re also printed in our literature.
To access these tools, please click on the links below. Or, call our customer service at 1-877-273-1683 to request a copy of our literature. We will always be happy to assist you in achieving successful insurance claims for your customer.
- Click here for Bellisse suggested insurance codes. (PDF document)
- Click here for Bellisse sample letter of medical necessity (PDF document)
Remember: Truncal Lymphedema is usually chronic, so if you go the extra mile to help a customer with insurance reimbursement, you may have an appreciative customer for life! Also, your extra efforts will set a benchmark for future submissions and will help ensure a more successful submission next time around with that insurance company. Guiding one woman’s claim through the system will help make the claims process much smoother for the women who come after her.
I’m a Bellisse dealer. How can I help my customers receive insurance reimbursements for the Bellisse® Compressure Comfort® Bra?
Bellisse dealers all over the United States are reporting excellent insurance reimbursement results for the Bellisse® Compressure Comfort® Bra – similar or even better reimbursement results than for compression garments for the limbs!
Of course, there are still a few troublesome HMOs or private insurers who may reject a claim for reimbursement on the Bellisse Compressure Comfort® Bra. This is when our patients need their dealers to be their advocates, their “Claims Champions!” Becoming a Claims Champion will help both your current and future customers, and is a great way to win customer loyalty.
The good news is that we have found some techniques for preventing insurance claim rejections from occurring in the first place, and we have several useful suggestions for women who are denied coverage.
The most successful formula is simple. Just be sure to always submit the following with each claim:
- A doctor’s prescription
- A letter of medical necessity, and
- An appropriate Miscellaneous Lymphedema insurance code (NOT a mastectomy code such as L-8000, which doesn’t work).
- That’s it!
Bellisse has conveniently provided all these tools (codes, sample letter of necessity, etc) on our website, www.bellisse.com. They’re also printed in our literature.
To access these tools, please click on the links below. Or, call our customer service at 1-877-273-1683 to request a copy of our literature. We will always be happy to assist you in achieving successful insurance claims for your customer.
- Click Here for Bellisse suggested insurance codes. (PDF document)
- Click here for Bellisse sample letter of medical necessity (PDF document)
Remember: Truncal Lymphedema is usually chronic, so if you go the extra mile to help a customer with insurance reimbursement, you may have an appreciative customer for life! Also, your extra efforts will set a benchmark for future submissions and will help ensure a more successful submission next time around with that insurance company. Guiding one woman’s claim through the system will help the many women whose claims will follow.
Patients Have Power
At Bellisse, we always encourage patients to help in the fight to gain insurance recognition. A patient can contact her insurance company herself or ask her human resources department at work to do so. If a claim is rejected, a patient should lodge a complaint about being denied coverage as a breast cancer survivor for products that are medically necessary. An insurer may not want to “rock the boat” over the denial and may well go ahead and approve the claim when challenged. Making some gentle “noise” (provided all the supporting paperwork is filed correctly) is usually quite helpful and effective!We also strongly encourage our Bellisse Dealers to be champions for Truncal Lymphedema patients and to submit appeals on their behalf. Below is a link to a very helpful sample letter for patients whose insurance companies have refused to give them reimbursement/coverage for compression bandages or garments. Be sure to read the letter carefully and fill in the blanks as necessary, customizing it to your specific situation. Have your physician sign and send it, retaining a copy for your records.
http://www.lymphnet.org/lymphede maFAQs/insuranceIssues.htm
Remember that the law is on your side: According to the Women's Health and Cancer Rights Act of 1998, breast cancer survivors may not be denied insurance coverage for medical care and devices needed to manage post-cancer side effects, including lymphedema. For more info, visit the Bellisse website at http://www.bellisse.com/pdf/cancer-rights- act.pdf, or go to the US Department of Labor Employee Benefits Security Administration website: http://www.dol.gov/ebsa/publications/whcra.html
The key to successful insurance reimbursement, for current lymphedema sufferers and those who will follow, is to be PERSISTENT AND CONSISTENT. If you or your customers are denied coverage, don’t take no for an answer. Together we all can make a difference in the quality of life for the women suffering from Truncal Lymphedema!
Lightning 2, LLC