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[wHEELCHAIR/SEATING] From start to finish, the wait for a chair is often two to three months, stated Mulligan. The professional team obtains a prescription and all necessary paperwork. Mulligan writes a letter of medical necessity for the wheelchair to justify reimbursement through the patient’s insurance company, provided all qualifications are met. The vendor sends the letter with their own forms to the physicians for approval. “Once we get approval for the chair, we fit the patient in the chair and do final adjustments before releasing them,” Mulligan said. “After a month, they may come back with adjustments that suit their needs better.” The Funding Piece A physician’s order for the purchase of equipment is necessary when funding is being sought from a third party payor such as an insurance company, Medicare or Medicaid. Although a medical supplier or vendor can be directly contacted for a home visit, Mulligan does not advise this route. He stresses the importance of being evaluated by a physical 26 ADVANCE for Physical Therapy & Rehab Medicine or occupational therapist. Medical suppliers and vendors are not able to accurately assess the person’s body contours and angles to determine the best type of seating system. Mulligan recently assisted a woman with an older diagnosis of multiple sclerosis. Her condition was getting progressively worse and she was relying on a basic power wheelchair prescribed many years before visiting SLRC. “When I first met with the patient, she was in desperate need not only for a new wheelchair but one that would now provide appropriate power seating features,” Mulligan shared. “I recommended a brand new power wheelchair with power tilt in space, power recline and power elevating leg rests.” These features were imperative and medically necessary for her as her condition had worsened. “After several months of awaiting approval, her insurance company denied the new wheelchair and all of the features we had recommended,” Mulligan relayed. After a first appeal, she was denied again. “We took her case to a second appeal which included a phone hearing with a judge who listened to my arguments for the chair and the insurance company’s argument against the chair,” Mulligan said. In the end, the denial was overturned and the patient recently received her much-needed new power wheelchair. “In this scenario, the hard work and effort that went into prescribing and following up with a wheelchair prescription paid off immensely,” stated Mulligan. “I got to see the patient receive what she needs and deserves.” SLRC’s 40-plus years of experience helps to make the experience as trouble-free as possible for everyone involved. “The long waiting period to obtain a chair for a patient is often due to an approval delay from the insurance company,” Mulligan shared. “It’s frustrating as a provider because my patients often needed and wanted the chair yesterday.” The process can be delayed by many other factors, too. The physician may not sign the paperwork promptly or a specific part may wheelchair continued on page 28
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Page 11 and 12: [uPPER-ExTREMITy REHAB] Diagnosis:
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