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Thread: Time to receive new power chair

  1. #1
    Senior Member landrover's Avatar
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    Time to receive new power chair

    Hi, I was evaluated for a new wheelchair at the end of February. It is been seven weeks since my evaluation and my vendor has still not submitted the claim to insurance for approval. I've complained to them about the time, but is this normal?

  2. #2
    Find a different vendor. This is excessive as long as they have the RESNA certified evaluation and your physician's signature on the letter of medical justification. If they don't have those, maybe the slow up is not with them. Did you ask them why the hold up?

    (KLD)

  3. #3
    Senior Member landrover's Avatar
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    Yes, they've had the evaluation and dr. signature for about five weeks now. They initially said the delay was due to them needed to code the various wheelchair parts, but that was two weeks ago.

  4. #4
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    It has been very frustrating for me too. I visited a hospital and met a PT and a sales person on Feb. 3. Next day, Dr's office faxed the letter to a DME store. Mine was finally ordered on April 1st and I expect to have a new powerchair maybe next week. I really cannot understand why it takes so long. My insurance company finished the pre-approval in a week.
    All delay was made at the DME.
    BTW, before they order the chair, I recommend you to review the order form and check everything is correct. I experienced a few times that a chair was not ordered correctly or the part was not what I expected.

    Good luck!

  5. #5
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    It took us almost a year to get Ry a downgraded chair. he has been in a power chair since his injury in 2009. He had all the doctors' on board but it took the DME provider nine months to get it through their internal pre-approval process before anything was sent to insurance or Medicare. By the time they got their finger out of their ear, our insurance changed (husband changed jobs) and the headache worsened. I wish I had another option for a DME provider. I guess we can go to Richmond (day trip to say the least) but this is beyond reasonable.

    At the same time that Ry's doc ordered a manual chair, the ordered replacement parts for his shower chair. The back is cracked (homemade fix in place but is temporary-we will redo as necessary), the arm padding is gone (got some foam tubing to cover pipes and used duct tape to secure). The worst problem is, of course, the wheels. The front casters are cleaned on a regular basis but they do not turn. Taking him to and from the shower is literally killing my back. Insurance has taken the Medicare approach to not covering roll in shower chairs. They will not tell me how they expect him to shower. They told me that his doctor can petition for an exception. I can only imagine how long that will take. I am wanting to buy one out of pocket for $250-$300. Even if it only lasts for a year, it will cost me less than the deductible if can ever get insurance to cover an Active Aid shower chair.

    I think that the fact that insurance companies are allowed to charge whatever they want and change the rules and coverage whenever they want has to end. The government regulates utilities, why not insurance?--eak
    Elizabeth A. Kephart, PHR
    mom/caregiver to Ryan-age 21
    Incomplete C-2 with TBI since 3/09

  6. #6
    Quote Originally Posted by landrover View Post
    Hi, I was evaluated for a new wheelchair at the end of February. It is been seven weeks since my evaluation and my vendor has still not submitted the claim to insurance for approval. I've complained to them about the time, but is this normal?
    I know how you feel. So far, it's taking two months from the start of meeting with the PT, wheelchair seating guy, and my face-to-face meeting with my doctor. I'm at the stage now where all the paperwork, forms, and evaluations are getting ready to be submitted to my insurance, for approval. I feel confident they're going to say "Yes" to my new power chair. Especially now since it was documented that I require it for mobility around my house. That, and it's been thirteen years since I've had my last power chair. If all goes well. I should have my new power chair by next month.

    One word of advice: Keep on your DME vendor with your order, and don't let them slack off on it. My DME has been pretty good with me in the thirteen years I've been doing business with them. Even though they are known for many mistakes, and mix-ups. They've messed up on my best friend's mobility requests a few times. With me. The only problem I've had with them was when they sent me the wrong size cushion. I got on their case about that, and had them correct that.
    Samantha

  7. #7
    My own experience with ordering wheelchair parts froma local DME supplier is that they "hold the order" as they get discounted prices from the manufacturer if they put in a higher dollar amount order, usually over some threshold. So if they can put in several orders at once, it saves them money. It's always about the $$$.

    Best, engineermom2

  8. #8
    Senior Member landrover's Avatar
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    It appears from others' experiences that this delay is unfortunately the norm, so I will just have to be patient.

  9. #9
    Quote Originally Posted by landrover View Post
    It appears from others' experiences that this delay is unfortunately the norm, so I will just have to be patient.
    What about contacting the doctor and therapist to see if they would help by calling the vendor.
    A specialist I see said to me about a new piece of breathing equipment, 'if the vendor calls you, don't bother dealing with them, tell them to call ME'. I had been having trouble for months with the vendor.

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