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Springtime in Vermont - Vermonters are hardy folks, but after a long winter we really appreciate spring! This time of year is full of optimism and fresh starts, and it’s the perfect time to take stock of where we’ve been as we prepare our individual and collective plans to move forward. A few years ago when we first envisioned a solution to compression management of the female torso, we felt like the proverbial lone voices in the wilderness. Although we knew we had created a product that could benefit hundreds of thousands of women, we had to persuade a lot of people that it would be worthwhile. And when we first started out, we didn’t even have the right words to use to talk about what we were trying to do: the word “truncal lymphedema” didn’t even exist in the medical vocabulary. We had to use the awkward (and not too catchy) nomenclature of “breast, chest and back lymphedema” to talk about the phenomenon we designed the Compressure® Comfort Bra to address. But now, thanks to you and others like you, we are no longer lone voices. Good listeners, concerned health care providers, and vocal patients are helping us raise awareness about (ahem!) Truncal Lymphedema. New research is being done and articles are being published that will inform and contribute to treatment protocols (see the Resources section of our website). We are very pleased and proud to have been catalysts for the positive changes we are seeing in the understanding and treatment of Truncal Lymphedema. And we are extremely gratified that the Compressure Comfort® Bra continues to be an effective solution for so many women, giving them hope for the next - shall we say - season of their lives. But we have a long, long way to go. Truncal Lymphedema is still under-diagnosed and far too often mis-diagnosed. Even today, the pain it causes can be dismissed as an “unavoidable” side effect of survival. And sometimes, even when Truncal Lymphedema has been identified in a patient, some health care providers still refuse to acknowledge its reality. We’ve just put up a case study of just such an incident on our website. Read about it below, and if you want to read more you can click through to our website to read “the rest of the story.” Just as our northern Spring insistently nudges its way past cold air and into frozen ground, so we at Bellisse warmly press our case. We started our Company not simply to sell a product, but much more importantly to raise awareness about a condition that can be effectively treated. Going forward, our mission will remain the same: to shed light on Truncal Lymphedema so that women can get correct diagnoses and good treatment, to help spark further discussion and research, and to provide a state-of-the-art product that can serve as an indispensable adjunct to current therapies.
Summer, we hope, is just around the corner!
What lies behind us and what lies before us
are tiny matters compared to what lies within us.
Can Ignorance Become Medical Negligence?
We recently received a riveting report from one of our colleagues describing an encounter with a former orthopedic patient who had in the interim become a breast cancer survivor. Although her symptoms perfectly matched the clinical profile for Truncal Lymphedema, and MLD treatment brought about an immediate and significant improvement, the woman’s cancer care providers insisted that the condition was not lymphedema. They dismissed her pain and her pain relief as being all in her head, and implied that the PT’s treatment was medically unnecessary. The patient felt her reality invalidated; she felt condescended to. She became wary of her oncology providers. The PT was dumbfounded. A lot of questions get raised here. Not the least of which: why is it so difficult to get women’s gender-specific health issues to be taken seriously by many in the medical profession? And when does professional ignorance approach medical negligence?
"Man," I cried, "how ignorant art thou in thy pride
of wisdom!"
For best comfort, wash before wearing! This will remove any sizing (i.e. stiffeners) in the fabric and elastics that remain present from their original fabrication in the mills, and will make the bra a bit softer and comfy-er right from the get-go. Remember, wash the garment either by hand, or in the gentle cycle of your washing machine. Keep the velcro straps closed to prevent snagging. Pre-washing is actually a good idea for any and all underwear you purchase (and for any garments that go directly against your skin!)
A recent article we came across cites research showing that on-line support groups help breast cancer survivors get over the “humps.” We’re not surprised. It’s one reason we created our Bellisse Discussion Board. Here are excerpts from some of the discussions we’ve been having recently: My girlfriend’s doctor, a breast surgeon, doesn’t feel you can get lymphedema in the breast. Can anyone help us [...] prove to her doctor that it does exist? I also have truncal lymphedema but my trouble is not in my breast or under my arm but my back shoulder blade area. My PT tried wrapping me but it’s so hard to get it to stay in place [...] What is kinesiotape? Click here to follow these and other topics on the Bellisse Discussion Board.
It can be tough trying to keep up with the latest “received wisdom” in medicine, because it changes so often! Just one example: here is an article we found in the NY Times questioning the Breast Cancer Genetic Test. Flaw Seen in Genetic Test for Breast Cancer Risk - New York Times
Bellisse Dealers: Don’t take ‘NO’ for an answer! Be a “Claims Champion” for Your Truncal Lymphedema Patients 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:
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.
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
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!
A New Feature Coming Soon To Our Site!
Watch for it! Lisa’s current favorite is:
PRONOIA is the Antidote for Paranoia (How the
Whole World is Conspiring to Shower you With
Blessings), by Rob Brezsny Fun and brilliant! This is the guy who does the quirky “Free Will Astrology” feature found in many newspapers. He has started what he calls the “Truth and Beauty Laboratory” to foster and encourage us all to become “Masters of Rowdy Bliss!” Truly an antidote to the ‘gloom-and-doom” crowd, and just what the doctored ordered in the “happy news” department. Makes you smile. Makes you think. A big paperback in workbook style.
If you have a favorite or particularly informative
book you think our readership would enjoy, please
post it on our Discussion
Board in "The Reading Room".
Click here to check out some of our other book recommendations.
As of January 1, 2006 Medicare has changed two of the recommended Bellisse miscellaneous submission codes: 2 of our “L” codes are now “A” codes:
So we now suggest using L-3999, E-1399, A-6543 or A-6549 for best chance of successful submissions for the Compressure Comfort® Bra. For a complete insurance submission guidelines, click here.
Spring being a tough act to follow,
This newsletter contains articles that we believe will be of general interest to the Bellisse community of lymphedema patients, their family and friends, and their health care providers. Sometimes, however, we have news and links that are of interest to only one of these groups. To be sure that you are you are in all the categories that interest you, please click on the "Update my profile" link at the very bottom of this newsletter. As always, Bellisse will not share your information with anyone else.
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