Another PWC Question

[mpnatx]

Had clinic on Wednesday and was given another prescription for a PWC. They wrote a script last time, but I didn't follow through. I have an older worn PWC that was given to me, so I let the script lapse.

The clinic has their own DME. But after he told me he only has Quantum wheelchairs, I already knew didn't want that chair because of the issues that have been raised here. Midwheel, jerky, shiny lemon, etc.

There is a Numotion dealer near where I live and am going to call them and set up a demo ride appointment. As so many have suggested here.

After reading previous posts, I have learned that other people will be involved during this process.

Does the DME set these people in motion? Or do I need to arrange everything? Would I just present the prescription to them? Or do they need to contact the Dr?

I have medicare and UnitedHealth supplement.

And, I want a permobil as so many PALS have recommended.

 

[lgelb]

The DME will need to work with your doc or likely a PT or OT in the office, if applicable, as Medicare requires certain documentation. If you already have an order for a PWC, Numotion should be able to get things going. Let us know what happens when you call Numotion; branches differ somewhat and they may require that the doc refer you rather than your referring yourself.

Note: Permobil chairs most applicable to PALS include the F3/F5 (front wheel drive) and M3/M5 (mid-wheel drive). The "5" versions of each are generally bigger, faster, seat goes higher. The "3" versions do offer anterior tilt, which can be helpful for PALS. You can see the differences in specs on Permobil's site, but many options have to be configured by the dealer [Numotion in this case if you use them], so be clear about your environment and needs.

A home assessment is always best, especially in homes with problematic measurements/obstacles/angles, but for those for whom that is not in the cards due to distances, you can measure and take pics, and require that your contact "check off" the chosen chair against each aspect.

Best,
Laurie

 

[KimT]

In my case, my local neurologist wrote the Rx. Then I called a dealer and they took it from there. They arranged to have a PT come to my home and do the initial evaluation. I had already drafted a letter outlining the features I needed and why I needed them. My local neuro was more than happy to put it on his letterhead because it elaborated on his clinical assessment. The PT who came said she thought the letter was well written and was planning on using it for her report as she also agreed with its content.

After the home evaluation, I was informed that they would move forward but, for some reason, I needed another face-to-face with my doctor after the evaluation. No problem, he is just 20 minutes away and I see him every other month.

Once that was done a representative from Ability Medical Supply came out and did measurements. In a couple of weeks they came back with two chairs, one Permobil and one Quantum. They heavily sold the Quantum and that chair was brand new. The Permobil was way too big and old. They really pushed the Quantum telling me they could give me the elevation function free while I would have to pay $2,800 for it if I got the Permobil.

After they left I called Permobil and told them the story. Permobil sent their regional rep out with two Permobil models and about a dozen different seat cushions and other accessories. She was here for about 3 hours and encouraged me to take my time.

I decided on the mid-wheel Permobil and there was a problem between my doctor's office and Ability. Each saying the other had not faxed the paperwork. This went on for about a month. Finally, Ability called me and said everything was a go except I'd have to pay for the elevator function. I told them to cancel the order. After another week, Permobil said they would comp me the elevator function.

All this has taken five months but I will end up getting the chair I need and want along with the seat I want and everything will be paid for.

It should be here in a week or two but I'm in no big hurry.

 

[Diane H]

First, make certain that the vendor is a Medicare approved DME provider and in-network for the United Health Care policy if in-network is required.

An Occupational Therapist from the clinic usually works with the vendor to write up the requirements, addons, etc. for your chair. This assures that people familiar with ALS, chairs and the available adaptations, paperwork. are involved. A wheelchair rep will be more than happy to do it alone, but be certain that they have worked with the clinic,'s ALS patients before and are aware of the needs of ALS patients. lf a therapist is involved, he/she will complete the forms to justify your need for a power chair and all the add-ons (tilt, recline, etc.) Knowing the right codes and buzz words to use is critical in the process of getting your chair. Errors or omissions will delay insurance approval by a couple of months.
Next the paperwork must be signed off on by the durable medical equipment provider (vendor) who will actually order the chair from the manufacturer.
The order won't be sent however, until a physician also signs the papers. They then go back to the therapist or vendor to be sent to Medicare/insurance company.

Because of this process, the traveling paperwork can get stalled anywhere along the way. Be a pest and call the therapist, if one is involved, in a couple of weeks to find out how far the paperwork has gotten, and continue to check on it until it has been signed by the doctor (a common spot for the paperwork to get stuck in a stack of waiting paperwork), and sent to Medicare/insurance company for approval. The chair won't be ordered from the manufacturer until approval is received by the vendor. Once you are told that the paperwork has gone to Medicare/insurance, call the equipment provider every month to track progress. Expect a minimum of three months and more likely at least six months to get the chair approved, built, delivered, and final adjustments made.