For Providers
Referring a patient to Bonjour Medical is simple, whether they're covered by workers' comp, the VA, or paying on their own.
Three ways we serve your patients
Workers' Compensation
We coordinate with adjusters and case managers, including prior authorization and LMNs.
How to refer →Veterans (VA)
Registered federal contractor working directly with VA contracting officers.
How to refer →Self-Pay Patients
Patients see the system in your clinic, then buy online. Your staff sends the prescription; we deliver.
Patient program →Self-pay program for your practice
- Show the patient the system using the demo unit we provide for your clinic.
- If the patient wants it, the provider writes the prescription on our self-pay form, checks that the wrap fits, and your office faxes it to 804-767-2150. If the wrap won't fit, check "Wrap will NOT fit" and let the patient know not to purchase. Sales are final, and we can't accept returns for fit.
- Hand the patient our QR code card. They create an account and buy online, ideally before they leave.
- We handle the rest — payment, ground delivery, patient questions and warranty service. The patient's card is approved at checkout but only charged when your Rx arrives, so please fax it the same day. Orders with no Rx after 7 days are cancelled.
Age and contraindications: the ManaMed user manual states, "The device is intended for use by adults (age≥ 22 years)." Use in a patient under 22 is the prescriber's decision; please discuss it with the patient and their family. Please don't prescribe if an IFU contraindication applies, including suspected, active or untreated deep vein thrombosis, ischemic vascular disease, severe arteriosclerosis, pulmonary edema, heart failure, thrombophlebitis or an active infection; neuropathy; or significant vascular impairment in the affected area. The full list is on our safety information page and on the back of the patient handout.
Patients who heard about us from a friend may also bring you our self-pay (cash-pay) prescription form. You don't need a demo unit for this; just confirm the wrap fits on the form before the patient buys.
Why all sales are final
We built this program to get your patients the best possible price. Returns, restocking, overnight shipping and phone support all add cost, and that cost ends up in the price. By leaving them out, we pass the savings to the patient.
That's why we ask you to demo the system and confirm the wrap fits before the patient buys. Once purchased, all sales are final (no refunds or exchanges, including for fit). Patients are still covered by a warranty on the pump (1 year) and wraps (6 months), and they get setup videos, how-to guides and email support. We ship by ground only, so patients should buy the same day.
Want handouts for your office? Email admin@bonjourmedical.com and we'll send program materials and pricing for your team.
Documentation we typically require
- Signed prescription specifying the equipment
- Patient diagnosis codes (ICD-10)
- Workers' comp and VA: Letter of Medical Necessity or chart notes, plus payer details (VA authorization or claim number)
- Patient contact information for delivery
Send a Referral
Workers' comp or VA referral? Email admin@bonjourmedical.com or call 804-767-2046 before you send anything. We'll walk you through exactly what we need for that patient and payer.
Self-pay (cash-pay) patients: fax our self-pay prescription form to 804-767-2150. This form is for cash-pay purchases only.
Documents can be faxed to 804-767-2150 or sent by secure email (Paubox) to admin@bonjourmedical.com.
Phone: 804-767-2046 | Secure email (Paubox): admin@bonjourmedical.com
Address: 4392 Dominion Blvd, Glen Allen, VA 23060
