Results 1 to 8 of 8

Thread: Insurance company PT recommended a Rigid Ultralight, was approved for Standard Chair

  1. #1

    Insurance company PT recommended a Rigid Ultralight, was approved for Standard Chair

    I have never seen anything like this happen. I was evaluated by the insurance company PT, who wrote up a plan and recommended a Rigid Ultralight. The same type of chair I have used for 23 years as a Para. My doctor approved the plan and it was sent for approval. I received a letter from Kaiser saying I was approved for a Standard Wheelchair (K0001). I thought there was some sort of mistake that I could workout once the DME met with me, but today I got a call from a shipping company trying to deliver me a wheelchair. I can't believe they are trying to send me a giant, heavy, standard hospital wheelchair. I have tried contacting the PT and my Doctor but they are currently not available. I of course will not take delivery of the wheelchair. Has anyone else had anything like this happen? I thought they usually only sent people Standard Wheelchairs for short term use, not for someone with a permanent disability.

  2. #2
    Did they fit you for one? Go over order options? I would like it would be tough for them to go through the entire fitting process then just send you any old chair?

  3. #3
    Many Kaiser insurance plans have no DME coverage at all, so I am actually not really surprised. It sounds like the PT and physician messed up on not assuring that what was prescribed was actually approved. Were your previous chairs provided under Kaiser or a different insurance? You need to file an appeal with Kaiser, and ask that your appeal be reviewed for medical necessity by a physiatrist. You have the right to request the specialty of the physician who is reviewing your appeal. Good luck!

    (KLD)

  4. #4
    Quote Originally Posted by SCOTTYB View Post
    Did they fit you for one? Go over order options? I would like it would be tough for them to go through the entire fitting process then just send you any old chair?
    The PT said that the DME would call me for an appointment to be fitted. The next thing I hear a Standard Wheelchair is being delivered to me.

  5. #5
    Quote Originally Posted by SCI-Nurse View Post
    Many Kaiser insurance plans have no DME coverage at all, so I am actually not really surprised. It sounds like the PT and physician messed up on not assuring that what was prescribed was actually approved. Were your previous chairs provided under Kaiser or a different insurance? You need to file an appeal with Kaiser, and ask that your appeal be reviewed for medical necessity by a physiatrist. You have the right to request the specialty of the physician who is reviewing your appeal. Good luck!

    (KLD)
    My plan shows Medicare Approved DME is covered with 0 copay. I am hoping it is just a mistake.

  6. #6
    It turns out that it was a mistake and they are now sending me to a seating specialist and I will be able to place my order for a rigid ultralight.

  7. #7
    Quote Originally Posted by KeepRollin' View Post
    It turns out that it was a mistake and they are now sending me to a seating specialist and I will be able to place my order for a rigid ultralight.
    phew . . .
    Chas
    TiLite TR3
    Dual-Axle TR3 with RioMobility DragonFly
    I am a person with mild/moderate hexaparesis (impaired movement in 4 limbs, head, & torso) caused by RRMS w/TM C7&T7 incomplete.

    "I know you think you understand what you thought I said, but what I don't think you realize is that what you heard is not what I meant."
    <
    UNKNOWN AUTHOR>

  8. #8
    Quote Originally Posted by chasmengr View Post
    phew . . .
    No kidding. What a relief.

Similar Threads

  1. Replies: 20
    Last Post: 09-18-2015, 04:30 AM
  2. Looking to buy used ultralight/rigid frame chair.
    By onetimebuyer in forum Equipment & Services
    Replies: 2
    Last Post: 10-31-2012, 06:13 PM
  3. medicare approved supply company
    By vjls in forum Equipment
    Replies: 1
    Last Post: 10-25-2012, 08:02 PM
  4. Replies: 32
    Last Post: 12-02-2011, 11:29 PM
  5. Recommended Sources of Ultralight Wheelchairs?
    By mgwmgw in forum Equipment
    Replies: 5
    Last Post: 09-20-2010, 12:05 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •