Therapists

Introduction

MZ CustomFit provides multiple services to our therapist. We have a network of mobile and virtual fitters that can assist therapists in providing top quality lymphedema supplies to their patients nationwide. We also can provide billing services for your patient’s lymphedema supplies and garments if you want the do the measuring. Our team gets the insurance verified, can measure patients if preferred, order products, delivery products, handle payments, and track when it’s time to reorder. MZ Customfit is extremely successful in the insurance verification and claims process and have access to hundreds of insurance contracts and networks. In addition to a mobile fitter network, we have several brick-and-mortar retail stores located in NC, OH, and TX. MZ CustomFit specializes in billing lymphedema, mastectomy, medical bracing and breast pumps.

Some of our products include:

Custom compression garments and ready to wear
In-elastic/Velcro Garments
Nighttime garments
Bandages and wraps

Custom breast prostheses
Compression and mastectomy bras
Compression pumps and appliances

In the event that insurance doesn’t provide coverage for certain products or deductibles are too high, we are competitively priced for out-of-pocket payment. We also offer payment plans for those that qualify.

Getting Started

Below is a list of forms that MZ CustomFit needs to verify insurance benefits, place orders, and process claims.

You can upload them directly to our website through the document upload link, send them via email to support@mzcustomfit.com, fax them to us at (877) 890-7749, or submit them through the portal links.

Once MZ CustomFit receives the patient referral forms, we will contact the patient and review the financial responsibilities for the requested medical products and go over the stages of our process. Our customer support team will be in constant communication with the patient about their order and future reorders.

INSURANCE VERIFICATION ONLY REQUEST FORMS:

Face Sheet with demographic information from clinic
Initial Request for Compression Services Cover Sheet
Portal Link | PDF Download
Patient Forms Bundle – Notice of Privacy Practices and Authorization to Disclose – MZ CustomFit – Portal Link | PDF Download
Copy of Insurance Cards – front and back

PATIENT REFERRAL FORMS:

Face Sheet with demographic information from clinic (Make sure the referring physician and contact information is included on paperwork).
Initial Request for Compression Services Cover Sheet
Portal Link | PDF Download
Patient Forms Bundle – Notice of Privacy Practices and Authorization to Disclose – MZ CustomFit
Portal Link | PDF Download
Copy of Insurance Cards – front and back.
Therapist Evaluation – Plan of Care (POC)
Products requested with Measurement Form(s)
All Forms

MZ CustomFit will obtain a Certificate of Medical Necessity (CMN) from the referring physician for the products requested. This is necessary to submit the claim to the insurance company for payment. Please make sure that the referring physician and contact information is included.

We appreciate your referrals and look forward to working with you!

Forms

We offer a variety of forms, including those for product fitting and measurement. These forms are available for PDF download or can be filled out online through our custom portal. Click below to view all available forms.

Let Us Do The Measuring

MZ CustomFit can work around your patient’s schedule and comfort level. We can come to your clinic, they can visit one of our many retail office locations, or we can visit your patient’s home. We also offer Virtual Fitting Services.

FAQ

How do I refer a patient to MZCustomFit?

Getting Started with MZCustomFit

Step 1: Submit the Patient Face Sheet with Referring Physician, Plan of Care, and Copy of Insurance Cards

Step 2: Submit the Request for Compression Services Document

Step 3: Submit the Patient Forms Bundle - Notice of Privacy Practices & Authorization to Disclose

We will take it from here!

Ways to Submit Your Forms:

Upload, Email, Fax, or Submit through the Portal Links
support@mzcustomfit.com
Fax (615) 523-2953

What if I need to consult with a MZ CustomFit representative regarding insurance benefits for my patient?

All of our team members at MZ CustomFit are well-informed in insurance benefit particularities. Feel free to contact us if you have any questions regarding your patient’s benefits.

What if I need to consult with a MZ CustomFit representative regarding product options for my patient?

Our representatives have taken the time to receive certification by individual manufacturers and will gladly discuss your patient’s product options based on relevant, current, and detailed product information. Feel free to contact us to discuss your patient’s product options.

What if I have a very difficult case and need to consult with a Certified Fitter from MZ CustomFit regarding product options for my patient?

When encountering a case that may require further clinical assistance, please feel free to contact us directly. We have certified fitters with all manufacturers. We will be glad to speak with you via phone or email on how to best complete the case. Our direct line is (833) 488-1905, or send us an email at support@mzcustomfit.com. For efficiency in understanding your patient’s needs, if possible, please send us any combination of the following items:

Pictures
Measurements
Patient History
Physical/Initial Evaluation
Past modalities tried

How do I receive confirmation of order receipt, and the order placement?

We correspond with therapists through faxes in order to keep the therapist up to date on the patient’s order.

What if my patient receives a product that does not fit correctly, requires higher/lower compression, or requires a change of fabric?

At MZ CustomFit we are here to assist you in providing clinically efficacious products to best meet your patient’s needs. If the product does not fit properly or there is a problem with the fabric used, we will work closely with the manufacturer to remake the garment with revised measurements or replace the product with a different fabric or compression.

If the returned merchandise is determined to be defective, the manufacturers, at their discretion, may replace the merchandise. A Return Merchandise Authorization number (RA number) must be obtained prior to any returned requests. MZ CustomFit will provide a return authorization packet to the patient consisting of an RA letter, shipping label, and a prepaid FedEx label. Our customers have a thirty day period after receiving a product to contact us, otherwise, we have lost our lead-time from the manufacturers to request a return authorization.

Do you mail out reminder cards to patients so they know when it is time to reorder their daytime elastic support? As you know, the elastic support is no longer providing adequate compression after it loses its elasticity.

Yes, we will send out reminders to patients as to when they are eligible to reorder their daytime elastic support products according to their insurance policy guidelines.

Who obtains prescriptions from the referring physician to file your claims?

MZ CustomFit handles all paperwork. After our clinical history form and product information form are received, we have the necessary documentation to facilitate a certificate of medical necessity to the referring physician for signature.