General FAQs
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Yes, our specialized fitters and cosmetologists work personally with each guest and we want to make sure there is enough time allotted. We welcome you to stop in to pick out scarves, hats, swim suits, or just to see what we offer.
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If we are billing your insurance* for your prescribed items, please bring along your insurance cards (Primary, Secondary, Tertiary, etc)
Also, you will need a to bring along your current prescription for the billable items. You may choose to have it faxed over by your medical practitioner’s office. Our fax number is (920) 393-4913.
* Prior approval is required from your insurance on items prescribed prior to purchase.
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We schedule an hour and a half to our guests who are undergoing hairloss due to chemotherapy. Some appointments take 20 minutes, some the entire scheduled appointment if you also want to look at hats and scarves.
For our first time guests – being fitted for bras and prosthesis, expect an hour and a half. Some appointments do not last as long especially if you have experienced fittings in the past and know what you are looking for.
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Bras and/or Prosthetics
If you are a new guest to us, and we are billing your items to your insurance company, you will need to schedule a New Guest Fitting with our Certified Mastectomy Fitter.
If you have been fit previously within the past year, you have not experienced any weight loss or gain, and all your items are fitting well, but need new from wear, feel free to call or email us your order.
Wigs or Toppers
No, feel free to call or email us and we will verify if the item is available.
Insurance
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Start with your primary insurance company. The number for customer service will be located on your insurance card. If your primary does not cover your item, call your secondary, tertiary, etc.
Find out if the item(s) you medically need (have a current prescription for) are a covered benefit under your insurance plan.
If the items are covered under your insurance plan, find out how many you are allowed per year and how many you are allowed at a time. (Quantity/Frequency)
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If we are an in-network provider for the item(s) you are purchasing, yes, we will bill your insurance directly. You will still need to meet your deductible, pay for any co-insurance amounts, and above and beyond. These are due at time of service.
Bring along to your appointment, your insurance cards (Primary, Secondary, Tertiary, etc) and a current prescription for items needing to be billed.
Please arrive for your appointment 10 minutes early to fill out the proper insurance paperwork.
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Generally, if we are an out-of-network provider, we encourage our guests to contact their insurance to see if they will allow this particular purchase to be covered at an in-network level. Insurance companies call this a pre-authorization or a network gap exception.
A network gap exception is a tool health insurance companies use to compensate for gaps in their network of contracted health care providers. When your health insurer grants you a network gap exception, also known as a clinical gap exception, it’s allowing you to get health care from an out-of-network provider while paying the lower in-network cost-sharing fees.
You will still need to meet your deductible and pay for any co-insurance amounts, and may be requested to pay these at time of service.
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We highly recommend you contact your insurance provider to confirm coverage for the items you are looking to be reimbursement for. If your insurance says they will cover the items, please be proactive, get everything in writing or a reference number, including the insurance representatives name you spoke with.
You will also need to obtain a prescription for medical necessity, from your medical practitioner, for the billable items. Bring this with you to your initial appointment. You may also have your practitioner’s office fax it to us at (920) 393-4913.
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Most insurance policy/plans cover what Medicare deems medically necessary. Medicare does not cover mastectomy swimsuits or swim prostheses. We encourage you to check with your individual insurance policy or Health Savings Account (HSA) to find out your benefits.
Mastectomy Boutique
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If we are billing items to your insurance company, it is required by insurance guidelines, you will need to be fit by a Certified Mastectomy Fitter.
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Because each woman heals at a different rate, we recommend you contact your medical provider to see when you are able to be fit for your bras and prostheses. We require that your drains are removed, any incisions and swelling is healed.
If you are needing Post Recovery garments, we offer these in a variety of sizes and styles. Check with your medical practitioner which items are recommended.
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We schedule an hour and a half for our new guests being fitted for the first time at our boutique. We take extra time is built in to make sure you are being fitted properly for your items, answer any questions you may have and go over paperwork required for billing. We encourage you to arrive at least 10 minutes prior to your scheduled appointment to fill out insurance paperwork.
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The majority of insurance companies use Medicare as a guideline for replacement of items. Medicare allows your items to be replaced based on medical necessity. If you have had weight loss or weight gain, your items most likely are not fitting you properly. If your bras are worn or stretched out, prostheses show signs of noticeable wear and tear, or your items have been lost or stolen, please meet with your medical practitioner to discuss with them about obtaining a new prescription for your items.
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Nell’s offers a variety of solutions from foam breast prostheses to silicone breast prostheses. Schedule an appointment with our Certified Mastectomy Fitters to see how we can help you feel and look balanced.
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If you underwent a lumpectomy due to breast cancer, your insurance may help you pay for the items you need to look balanced. Please check with your insurance provider to confirm coverage for the items.
You will also need to obtain a prescription from your practitioner for the billable items.
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We carry a wide selection of mastectomy swimwear ranging in sizes from 6-26.
Our swimwear is available all year round and we stock 100% polyester suites, in addition to a variety of separates and tanks.
We also carry a selection of active and swim prosthetics.
Compression Wear
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Yes we do. Please schedule an appointment with our Certified Mastectomy Fitter.
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Yes we do. Our team can assist you with the proper fit for graduated compression socks and compression hosiery. Please schedule an appointment with our trained fitters.
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Yes, we carry Sigvaris Advance Armsleeve. Please schedule an appointment to be fitted.
The Advance Armsleeve combines the latest fabric technologies with a breathable top band for enhanced comfort making it a leading treatment choice for patients with lymphedema. The Advance Armsleeve features:
A Sensinnov® grip-top to help keep the armsleeve in place without damaging the fragile skin of the upper arm
Thermal control & moisture-wicking properties to enhance comfort for year round wear
Silver ions to help maintain skin hygiene
Availability in Regular and Long lengths
A Plus size option for the upper mid-arm
Wigs
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We recommend you set up an appointment as soon as you feel up to working with our licensed cosmetologists. It may help ease your mind starting this journey earlier to help you see options and feel comfortable with your new look, before you start experiencing any hair loss.
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We schedule an hour and a half for our guests who are undergoing hair loss due to chemotherapy. Some appointments take 20 minutes, some a hour and a half, depending if you would like to try on hats and scarves.
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YES! We highly encourage you bring along a friend or family member who knows you well. We have limited space and ask to consider 1–3 persons for honest feedback.