I used that title sarcastically. I’m not feeling too festive these days. Prescribing wheelchairs and other complex DME for my clients just keeps getting harder and harder. Read more
We all have much to be thankful for… and we know it can be taken away in the blink of an eye.
Taken away is what is going to happen in January of 2016 to those who rely on complex rehab technology (CRT) wheelchair accessories. Read more
Do you know what you need?
As the Funding Specialist for EasyStand, I am usually taking calls and reviewing Letters of Medical Necessity (LMN) about very specific standing devices. My most recent call reminded me of the importance of knowing what you really need and how to determine that need. Read more
I received an email from a physical therapist last week asking that I review her Letter of Medical Necessity (LMN) for a Bantam small for her pediatric consumer. She was sending her documentation to me before sending it to the CRT Supplier for prior authorization (PA) with insurance. I love that she was being proactive and having me review the LMN before submitting for PA, rather than after it’s been pended or denied. It just makes sense to have all documentation/LMN’s reviewed by another person before sending it off to make sure it’s complete and without errors. Read more
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 the insurance provider? Was good documentation submitted with the request? What was the reason given for denial? Had her brother appealed the decision? As I asked more and more questions it became apparent that Sara didn’t have the answers. All she knew was the payer said no and she really wanted to help her brother. Read more
In response to supplier demand, the EasyStand Evolv E3 was developed to lower the base price of an Evolv and make it more attainable in states with less than favorable reimbursement. The E3’s standard features are limited to the essentials, lowering the base price and allowing you to “build” on the options your clients need while staying within funding guidelines. The E3 is different from the Evolv in two ways: a no-tray chest pad replaces the black molded tray, and the foot plates are height-adjustable only. Read more
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 ago, we conducted our first ever Twitter chat session to address some of the most commonly asked questions from the community. Below is the list of questions and answers we compiled from this session. Read more
We walked into the building holding hands and breathing deep, unsure of what the next hour would bring. It’s that time of the year at school. End of the year testing, planning for the next, and the IEP (Individualized Education Plan) meeting. The last two years, no worries. We had a great team of teachers and therapists who knew Roa and his abilities. They were amazing at including him in the preschool routine and adapting things to suit his needs. But this year, the game has changed. Roa is entering Kindergarten this fall. He is changing teachers, therapists, bus drivers and school building. This IEP meeting was entered with a touch of anxiety and a pinch of apprehension. Read more
In episode #104 of No Free Rides, Katy Blake, injured in 2010 on a canoe trip, shares her journey post-injury about navigating the less-than ideal Medicaid situation in the state of Mississippi. Read more
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 exactly why the National Coalition for Assistive and Rehab Technology (NCART)‘s Standing Device Workgroup was formed to create the Standing Device Funding Guide. Read more