Power Chair - Qualifying & evaluation

Texas Quilter

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I know I'm going to need a power chair - and that time is getting closer. I can still walk around my apartment, but some days not so good. My ALS Clinic has said that I will need to come there to be evaluated for need & qualification (Medicare). Its 700 miles away and I don't think I can travel there until maybe March. Also I don't want to go there and find out I can't get one. Just how "bad" do I have to be in order to qualify under Medicare guidelines. Can you share what your evaluation & experience was like?
Thanks so much
Dianne
 

lgelb

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Hi Dianne,
During the pandemic, CMS requirements have been changed so that the face-to-face eval and other PT/OT visits can be done via telehealth, as well as attempts to do remote repair consultations, ordering parts in advance, etc. You need a DME who is up on all this, as they typically drive the order process more than the clinic. Are you in a traditional Medicare or a Medicare Advantage plan (this may shape your choice of DMEs)?

You don't need to go to your ALS clinic to be evaluated -- why not deal through a center that is closer, like UMN in Albuquerque? (I guess I would also wonder why Albuquerque is not your clinic tbh.) You don't want your wheelchair supplier (DME) to be 700 miles away, either. Though there should be telehealth options as per above, you still want the closest possible center and DME, since you will still need a wheelchair evaluation to do measurements, etc. to determine what is ordered.

It may also be possible that a local PT could do the measurements with remote coaching from the DME ATP or clinic, and flip the form back to the authorized prescriber. People are willing to assist in these times, by and large, while working within reimbursement guidelines -- if they're not, frankly, you should find other people.

The last page of this document is the checklist for eligibility. With ALS, you are eligible for a Group 3 wheelchair. Any doc or PT worth their weight in salt can fill out the form to meet the criteria, most critically that you are at fall risk for any other mobility device that you are able to independently operate. So basically, they need to be able to say that you can't operate/perform ADLs using a manual wheelchair and a walker is unsafe.

Let me know if this is unclear...

Best,
Laurie
 

nona

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I don't know about the qualifications but Amarillo isn't in the middle of nowhere. the clinic should be able to refer you to someone closer or even a company that could come to you. I'm not buying that you have to go all the way to the clinic.
 

KimT

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My pain management neurologist here in Daytona Beach wrote the order for me. I got a recommendation from my local ALSA rep for a provider and the wheel chair people sent the OT and PT over to do the evaluation. I'm thinking the evaluation can be done via video with Covid. The only in-person contact, in my opinion, should be the provider who comes to your place to do the measurements for the chair. All my doctor did is give me an Rx for a PWC with a dx ALS and fibromyalgia. He thought the fibro added would cover better padded arms.
 

swalker

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Dianne,

I am glad you are looking into getting a wheelchair. I think you will find it greatly improves your ability to get around while conserving energy and reducing risks of falls.

You don't need to be "bad" to qualify for a wheelchair when you have an ALS diagnosis. You should not wait until you can no longer walk to get a wheelchair. Getting a wheelchair early in the disease process allows you to make decisions about how you expend your limited capacity for walking. You will reduce your risk of falling and will go places you would otherwise miss once you have a wheelchair.

In my experience, it takes longer than expected to actually get a wheelchair once the process starts. My first wheelchair took 4 months from the first visit to NuMotion until the wheelchair was delivered. I had the prescription for a month before that and my neurologist had started recommending a wheelchair a year before that. My message is, don't wait like I did. Start NOW.

As others have said, you should be able to get a wheelchair working with folks locally in Amarillo.

Any doctor can write a prescription for a wheelchair. My last wheelchair prescription was written by my local PCP. That saved me the two hour (each way) trip that would have been required to meet in person with my neurologist.

There are many places in or near Amarillo from which you can procure the wheelchair. For example, there is a NuMotion (one of the largest wheelchair providers in country) office in Lubbock and Mobility Solutions is in Amarillo. Most of the major firms will accept Medicare.

I recommend you consider getting your wheelchair locally. They are complex machines and can break. When they do, you will need to get it serviced. I needed quite a few adjustments in fit during the first few months of ownership as well. Most organizations will send a mobile technician to your location for repairs, but sometimes I find that it is either better or even necessary to take my wheelchair into their shop.

In fact, we just made the trip to Denver yesterday to drop off my Permobil F5 wheelchair for some extensive work.

As an aside, my father was born in Hale Center (between Amarillo and Lubbock). My grandmother was raised in Levelland (west of Lubbock). We drive through Amarillo every year (except this year) on our way to San Antonio to visit family for Thanksgiving. Somehow, the high plains always feels a bit like home to me, though my wife cringes everytime I say that:).

Steve
 

Texas Quilter

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Thank you Laurie. I've thought about Albuquerque . My neurologist here sent me to the Houston clinic originally - he has a good relationship with Dr Appel there. I've asked them about Albuquerque and Dr Appel said the doctors there are excellent. I might make the switch.
The info you sent about the power chair is helpful - thanks again! I think there is a DME in Lubbock.
 

Texas Quilter

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Steve - thanks for your encouragement and advice. I've been concerned that the time to get a chair might be delayed due to Covid. I got my scooter from Mobility Solutions here in Amarillo and think they are great people. I think NuMotion is the DME that usually works with the Houston ALS Clinic. I'll check with Mobility here and down in Lubbock.
My husband's family was from Abernathy and some family members are still there and in Lubbock - and here of course. Me, I grew up in Florida, but I love the high plains and Amarillo !

I'll get moving on this process. Thanks again
Dianne
 

KimT

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Let us know how it goes, Dianne.
 

lgelb

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If you like where you got your scooter, ask them for a recommendation for a DME as well. Not all Numotions are created equal, same for other chains like NSM. Independent shops, a dwindling breed, are often best if/as available. The DME doesn't have to have worked with the clinic before, but even if you go the PCP route, someone has to take the lead on the actual order specs -- some PCPs would have no idea, some DMEs want a PT/OT to take the lead, you get the idea. So the goal is to find one person from within the DME/clinic pool who can evaluate you for the specs and write them up. There are a lot of nuances. It's a big form. And not getting it right the first time would be costly on several fronts. But there is also adjustment later, thus the need for proximity.
 

MToole

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I recently replaced my Permobil M300 with a M3 through NuMotion.
The process went rather smoothly.
You will need to engage the doctors office at some point. You should be able to do this by telehealth.
You can contact the wheelchair maker and ask them who their local representative/vendor is such as NuMotion.
The vendor should guide you through all the steps.
 
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