FAQs
HOW DOES PAYMENT WORK?
CERTIFIED LYMPHATICS, we prioritize your care. We request payment for physical therapy services at the time of service. Your credit card on file will be charged accordingly. Since we operate outside of commercial insurance plans, we are able to provide you with the highest quality of care, develop treatment plans on your needs, not what is dictated by your insurance.
CANCELATION, NO SHOW, AND LATE ARRIVAL POLICY
Please note the following policies: If you cancel less than 24 hours before your appointment or do not show up, a charge of $75 will be applied to your credit card on file. Additionally, you may be discharged if you have two cancellations or no-shows. For late arrivals, we will still accommodate you; however, please be aware that you may not receive the full treatment time unless there are no other clients scheduled afterward. Thank you for your understanding!
CAN I SUBMIT A CLAIM TO MY INSURANCE?
At CERTIFIED LYMPHATICS, we provide documentation to assist you in submitting your bill to your insurance if you choose to do so. Please obtain an order from your MD for therapy to include with your submission. We cannot guarantee charges will be reimbursed. We recommend contacting your insurance company to discuss the specifics of submitting claims for cash-based Physical Therapy services and to fully understand your policy.
WHAT IF I HAVE MEDICARE?
CERTIFIED LYMPHATICS is not enrolled with Medicare. This means we are not permitted to perform any services covered by Medicare. We can provide services that address fitness, prevention, or maintenance as these services are not covered by Medicare. Evaluations and “skilled” treatments are covered services by Medicare, therefore we are unable to see you for these appointments. Claims cannot be submitted to Medicare or a secondary insurance provider. If you have any additional questions about this, we can further explain this with a consultation appointment.
DO I NEED A PRESCRIPTION/ORDER FROM MY DOCTOR?
In the state of Illinois, physical therapy services can be provided without a physician referral. If you are under the care of a physician for the issue being treated, the MD must be notified within 5 days of the PT evaluation. If you are not making improvements in 10 visits or 15 days, you will be referred to your physician. If you choose to submit a claim to your insurance for reimbursement, you will need to obtain an order from your MD for “PT evaluation and treatment” with a diagnosis.
WHAT SHOULD I BRING TO MY FIRST APPOINTMENT?
Please bring all your compression garments and bandaging supplies you may have. If you have a home pump, please take a picture of it to show me (so I know what type of pump you have).
WHAT SHOULD I WEAR?
Depending on the location of your lymphedema, I may need you to be fully disrobed. I will provide you with a sheet to cover yourself for modesty and will uncover only necessary areas having treatment. You can bring your own sheet or blanket if you prefer. For range of motion, strengthening, and stretching appointments: loose, comfortable clothing to allow you to move unrestricted.
HOW MANY VISITS WILL I NEED?
The total number of appointments vary for each individual. When being treated for lymphedema it is important to have regularly scheduled appointments. Please refer to the Complete Decongestive Therapy section for full explanation of treatment of lymphedema. Treatment for other cancer-related deficits, appointments are usually scheduled 1-2 times a week but can be less frequent. If you plan to submit your claim to your insurance, there needs to be progress made towards goals, insurance generally will not re-imburse for maintenance therapy.
WILL MY INSURANCE REIMBURSE ME FOR MY THERAPY?
You will need to contact your insurance to find out if they will re-imburse you for your treatments at a cash-based clinic. You will need an order for your therapy from an MD. CERTIFIED LYMPHATICS will provide you with the necessary paperwork to submit a claim to your insurance. CERTIFIED LYMPHATICS is not responsible for contacting your insurance to determine your benefits (deductible, max out of pocket, and any restrictions they may have). CERTIFIED LYMPHATICS is not responsible if your insurance does not reimburse your claim.
ADDITIONAL INFORMATION ON SERVICES: Consultations: At Certified Lymphatics, we focus on educating patients about lymphedema and the benefits of Complete Decongestive Therapy. Our discussions help determine whether treatment is medically necessary or falls under Restore/Preventative Services. For clients with Medicare, we assess eligibility for our services, ensuring you receive the best support in managing lymphedema effectively and thriving in everyday life. Consultation does not include treatment. This is purely an educational session. Consultation is not required prior to any evaluation, treatment, or a restore/prevent visit. Restore/Prevent visits: Let us support your journey toward optimal health! At Certified Lymphatics, we specialize in empowering individuals to manage lymphedema and thrive through personalized care. We offer Restorative and Preventative visits tailored to clients seeking maintenance treatments or clients wanting manual lymphatic drainage after cosmetic surgery, for athletes, or for preventative care. MLD can provide relief of migraine headaches, fibromyalgia, rheumatoid arthritis, stress, fatigue, and more. MLD also induces general relaxation and detoxification. Restore/Prevent Visits are not reimbursable by insurance; therefore, clients cannot self-submit to their insurance. Please note, for Medicare clients, if it is determined during your visit that your services may be reimbursable by insurance, we will be unable to continue with your appointment. Your appointment will be cancelled, and a consultation fee will apply. Evaluation Level 1: Evaluation Level 1 required prior to Treatment Level 1. Evaluation for clients experiencing mild swelling in the arms, head/neck, breast, or trunk, especially those recovering from cancer treatments. It is also for clients with physical or functional deficits after their cancer treatments. Our Level 1 Evaluation will include range of motion and strength testing, and circumferential measurements of affected areas. We will create a customized plan of care tailored to your unique goals, empowering you to manage lymphedema and to improve your physical function. Evaluation Level 2: Evaluation Level 2 required prior to Treatment Level 2. For those clients diagnosed with lymphedema. Evaluation for clients experiencing swelling of the head/neck, arms, and legs regardless of cause. Our Level 2 Evaluation will include range of motion and strength testing, and circumferential measurements of affected areas. We will create a customized plan of care tailored to your unique goals, empowering you to manage lymphedema. If it is determined you need bandaging to reduce your swelling, a list of supplies you need to purchase will be provided at the end of the evaluation. Treatment Level 1: At Certified Lymphatics, we empower you to effectively manage lymphedema and/or your physical deficits from your cancer treatments through personalized therapies, including manual lymphatic drainage (MLD), stretching, strengthening exercises, and manual therapy. These appointments are those with mild lymphedema (that does not require bandaging) of the arm, trunk, and head/neck area as well as for individuals after breast cancer related treatments who are experiencing swelling, cording, range of motion and/or strength deficits. While we focus on your holistic well-being, please note that compression supplies are not provided: patients are guided to select necessary items from our recommended vendors. Experience tailored support designed to promote recovery and enhance your quality of life. Evaluation Level 1 required prior to treatment. Treatment Level 2: At Certified Lymphatics, we empower you to effectively manage lymphedema and/or your physical deficits from your cancer treatments through personalized therapies, including manual lymphatic drainage (MLD), stretching, strengthening exercises, manual therapy and gait/balance interventions. These longer appointments are for those suffereing from leg lymphedema and severe arm lymphedema. While we focus on your holistic well-being, please note that compression supplies are not provided: patients are guided to select necessary items from our recommended vendors. Experience tailored support designed to promote recovery and enhance your quality of life. Evaluation Level 2 required prior to treatment.
RESOURCES AND REFERENCES
Michael D. Stubblefield, The Underutilization of Rehabilitation to Treat Physical Impairments in Breast Cancer Survivors, PM&R, Volume 9, Issue 9, Supplement 2, 2017, Pages S317-S323, ISSN 1934-1482, https://doi.org/10.1016/j.pmrj.2017.05.010.(https://www.sciencedirect.com/science/article/pii/S1934148217306585)
Andrea L. Cheville, Karen Mustian, Kerri Winters-Stone, David S. Zucker, Gail L. Gamble, Catherine M. Alfano. Cancer Rehabilitation: An Overview of Current Need, Delivery Models, and Levels of Care. Physical Medicine and Rehabilitation Clinics of North America, Volume 28, Issue 1, 2017, Pages 1-17, ISSN 1047-9651, ISBN 9780323496735, https://doi.org/10.1016/j.pmr.2016.08.001. (https://www.sciencedirect.com/science/article/pii/S1047965116300638)
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Kim, S. J., Lee, J. H., & Lee, D. W. (2013). The effect of manual lymph drainage of the neck on EEG in healthy adults. Journal of Physical Therapy Science, 25(9), 1147–1150. https://doi.org/10.1589/jpts.25.1147
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Castro-Sánchez, A. M., Lara-Palomo, I. C., Matarán-Peñarrocha, G. A., Fernández-Sánchez, M., Sánchez-Labraca, N., & Arroyo-Morales, M. (2011). Benefits of massage-myofascial release therapy on pain, anxiety, quality of sleep, depression, and quality of life in patients with fibromyalgia. Evidence-Based Complementary and Alternative Medicine, 2011, 561753. https://doi.org/10.1155/2011/561753
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Castro-Sánchez, A. M., et al. (2019). Effects of manual lymphatic drainage on clinical parameters and health-related quality of life in women with fibromyalgia: A randomized controlled trial. Disability and Rehabilitation, 41(9), 1110–1118. https://doi.org/10.1080/09638288.2017.1423406
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Yuan, S. L. K., Matsutani, L. A., Marques, A. P., & Pereira, C. A. B. (2013). Effectiveness of different styles of massage therapy in fibromyalgia: A systematic review and meta-analysis. Clinical Rehabilitation, 27(10), 942–951. https://doi.org/10.1177/0269215513485906
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Happe, S., Vennemann, M., Evers, S., Bruchmann, R., Kloska, S., Riemann, D., & Berger, K. (2016). Lymphatic drainage massage for migraine: A randomized controlled trial. Neurological Sciences, 37(6), 1021–1028. https://doi.org/10.1007/s10072-016-2518-0
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