Compression Pump Documentation

How To Order a Pneumatic Compression Pump for Your Patient

Pretty In Pink Boutique features pneumatic pumps from Bio Compression Systems.  This page helps you determine:

  • How to refer your patient for the fastest service
  • How to best document the Plan of Care to meet Medicare and other insurance requirements for coverage
  • Where to find the forms you need

Start With Our Process Overview

We recommend you start with our Process Overview.  It answers all the most commonly-asked questions and provides a road map to make sure your patient gets the best treatment and meets eligibility for insurance coverage.

Once you’re familiar with the ordering process and ready to send over your referral, please complete the form below:

Pneumatic Compression Pump Referral Form

This form can be faxed or emailed to us using the instructions provided, and for fastest service please include the following when you submit the referral form:

  • Patient Demographics
  • Images of Insurance Cards (Front & Back)
  • Plan of Care / Office Notes
  • Any Additional Notes

What Happens Next

Our Case Manager will immediately begin benefits verification and schedule the required in-office assessment at our office in the Cool Springs area of Middle Tennessee.  We will work with you to determine the proper pump and garments to achieve the treatment plan and best utilize the patient’s insurance benefits.

Once any out-of-pocket costs are identified and the patient approves, we will finalize the order with you and the patient and prepare for at-home delivery and training.

Other Helpful Resources

Here are links to the most commonly-needed resources for medical professionals:

Documentation Requirements

Pump Referral Form

Pump Rx and Letter of Medical Necessity

Please don’t hesitate to call or text us with any questions or concerns at (615) 777-7465 or email referrals@prettyinpinkboutique.com to speak directly with one of our Certified Compression Fitters or our Pump Case Manager.