Yesterday I spoke with a very nice woman named Sara who was trying to assist her brother acquire a standing frame. Sara’s brother is 5 years post SCI, and his submission for a standing device was denied by his insurance. I asked my usual list of questions when speaking with someone in this situation: Who was […]
Nancy Perlich, COTA, ATP
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Entries by Nancy Perlich, COTA, ATP
As the Funding Specialist for EasyStand, I hear a lot of questions from people who are interested in acquiring an standing frame, but don’t know where to begin. Insurance coverage, whether public or private, can be extremely confusing to navigate, but I am here to help clear up some of that confusion. A few weeks […]
With over hundreds of research studies on standing and weight bearing you would think that both private and public healthcare payer sources would fund Standing Devices without a second thought. Unfortunately, in today’s ever shrinking insurance coverage and payment arena that is not the case. In fact, decreasing coverage and payment for standing devices is […]
In previous years our emphasis during CELA visits to our members of Congress was to educate them on what is Complex Rehab Technology. Complex power wheelchairs, highly configurable manual wheelchairs, adaptive seating and positioning systems and other specialized equipment (such as standing frames and gait trainers) are considered “Complex Rehab Technology” or CRT.
To family, friends and acquaintances who are outside of the Complex Rehab Technology industry: For over 25 years, I have had the privilege to work in an industry that creates products that improve the lifestyles and livelihoods of those who are unable to stand or walk- simple things that many of us take for granted […]
A while back I spoke with a nurse case manager about the need for a stander for her client. After a lengthy discussion about the individual’s medical justification; the nurse case manager informed me that standers turned into coat racks, and thus this payer program should not cover them. Further into my conversation with the […]
Who deserves to stand? A sixteen year old with cerebral palsy, a middle-aged male with a T7 Spinal cord injury, a seven year old with metabolic syndrome? They each sit in there wheelchair all day long and are at risk for many types of immobilization issues from contractures, pressure sores, digestion problems, and more. Most […]
Jeff told his DME (Durable Medical Equipment)/CRT (Complex Rehab Technology) supplier, “That’s crap! I will not accept a denial from my insurance company for the stander. I’ve got to have the stander at home to keep my leg range of motion. What can I do to fight their decision?”
Shane was denied power assist wheels for his manual wheelchair in Minnesota. Five different consumers cannot gain appropriate funding for their standers from private insurance in New York. Elizabeth’s power wheelchair was down coded to a less expensive wheelchair due to Medicare’s “in the home” rule. CMS (Center for Medicare and Medicaid) says that competitive […]
Part of my job at Altimate Medical Inc. is to help educate people on the process of purchasing a standing frame and writing a letter of justification for a stander. Below is a PowerPoint presentation on Funding & Documentation for Standing Frames that was recently presented to clinicians and complex rehab suppliers.