In the world of Health Care Insurance, certainly requirements and procedures are required, to submit and seek approval for this medically appropriate equipment. Whether it is ambulation assistance devices, seating and mobility, bed/mobility, toileting and bathing; the process and documentation requirements are very similar.
Any new equipment request, must include a prescription from the client’s physician, and most insurances are going to require progress notes. Progress notes are notes from a recent visit that explains client’s condition and limitations requiring the equipment being prescribed.
Additionally the physician will prescribe a seating/mobility/equipment assessment that will be conducted by an Occupational Therapist (OT) and/or Physical Therapist (PT), and the Equipment Supplier. This is usually a visit to the home or clinic, where the client is measured, and usually trialed with the same/similar equipment being prescribed to ensure the equipment is proper, and usable by the client and in their environment.
The Therapist (OT/PT) will create and supply a Letter of Medical Necessity (LMN) to the supplier and with the LMN, the Supplier will create a Detailed Product Description (DPD) and send these back to the physician to sign and return.
The supplier will then package the request to the insurance for consideration. Once approved, the equipment will be ordered, assembled and scheduled for delivery.
This Article was written by Carey Britton, ATP/SMS,CRTS, he can be reached at (954) 821-7322 or at firstname.lastname@example.org