What must physician write on script for Roho cushion & assistant driving controls?

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Buckhorn

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What must physician write on script for Roho cushion & assistant driving controls?

We will be going to the ALS clinic again soon. Since my husband can no longer effectively weight shift in his chair & lacks the arm strength to lift himself up to reposition, we will be asking for a script for a Roho cushion. What specific writing does the MD need to write for Med B. to pay? Inability to reposition as noted, plus signs of some skin breakdown along his spine and ishial tuberosities (sit bones) - those are a given. I was just wondering if anyone can interject what their physician wrote as rationale for this equipment. My PALS Permobil does tilt, recline, etc., but he still becomes quite uncomfortable in his chair after about 2 hours.

We would also like to request an assistant driving control as my PALS hands are very affected at this point and he cannot navigate well thru doorways, up thru the back of the van, etc.

Thank you for any advice!
 

lgelb

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Re: What must physician write on script for Roho cushion & assistant driving controls

You really want to work this through the DME. They understand the justification. The factors you mentioned will be sufficient in the right format. The clinic should have a process through which they send after-market orders like this through to the DME, who will send them to Medicare. The script doesn't go straight to Medicare; it has to be filtered through the supplier.
 

Buckhorn

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Re: What must physician write on script for Roho cushion & assistant driving controls

Yes, thanks Laurie. That's how we acquired Dave's chair, but writing up specific criteria/justification is not our neuro's strong suit, so to speak. The ALS team are all nice people and say all the right things, but I have lost faith in the process of actually following thru with prescriptions, etc. unless we are right there in front of them!! If I forget to get a prescription or order when we are actually at the clinic, we fall thru the proverbial crack and weeks of telephone tag, e/mails etc. go by without response. The chapter social worker is fantastic, but, as she once stated to me "unfortunately I can't write the prescription". I'm sure if she could it would be great. I just don't get it - our neuro has been a motor neuron/ALS specialist for years, but they do not seem to understand how to write prescriptions with proper justification. You mention "The clinic should have a process through which they send after-market orders like this through to the DME" I do understand that, but it has been our experience that if we do not tell the doctor pretty precisely what he needs to write down, then the DME tries to get ahold of them, don't get a response, finger pointing to who dropped the ball goes back and forth ........ This is what happened with Dave's power chair.

So, I am trying to circumvent this whole merry-go-round and go armed with the specific language the doc has to write out for the DME. Does this make any sense?
 

Vincent

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Re: What must physician write on script for Roho cushion & assistant driving controls

What he needs is a roho quatro 4" cushion. If you are being seen on clinic get the occupational therapist to write the scrip. They know what insurance needs to hear to fund this. They will also know how to adjust it for maximum benefit. You may want to see if the ALSA can help too. Hope that helps, I got one from ALS CANADA, no charge.
Vincent
 
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