I posted comments to Post #11 at this thread: http://sci.rutgers.edu/forum/showthr...ant-to-be-rich
The poster ("grommet") indicated earlier in the thread that he didn't have very good insurance and was paying out of pocket for his chairs. Others urged him to at least give the system a try. I started a "to do" list and hope others will add to it.
- First, get a face to face appointment with your physician to discuss the need for a new chair of the type you require. Make sure he understands the classes of chairs available and that your level of injury and previous chairs you have used make you eligible for the Permobil class you are interested in. At this meeting get a referral to a physical (PT) or occupational (OT) therapist for a wheelchair/seating evaluation.
- Make the appointments with the physical or occupational therapist.
- Through your contact with the Permobil regional representative in your area, get a name(s) of durable medical suppliers. Check with your insurance company to make sure the durable medical equipment supplier(s) you are considering are approved. Medicare and some insurance companies require that you deal with a durable medical supplier that has either a certified ATP (Assistive Technology Professional) or and SMS (Seating and Mobility Specialist) on staff who will be working in concert with the OT or PT to specify the chair and accessories you require. Don't be backward about voicing your opinion and desire for a specific chair
- Make sure you get copies of the OT or PT evaluation, the letter of medical necessity, and the specifications of the chair and all accessories. Go over these documents very carefully and make sure the correct diagnosis codes have been used, the letter of medical necessity is thorough and complete and discusses why the chair and accessories are necessary. I went through 3 iterations before everything on these documents was correct. Chances are you doctor will know less about the chair than you do and he won't take the time to vouch everything. He'll just sign where ever there is a "Sign Here" message flag. I arranged with my doctor that he wouldn't sign anything until I had a chance to make sure everything was in order.
- Once the documents have been sent to your insurance company, call them and ask to be assigned to a special case worker who will be your liaison through the entire process. Stay in contact with the durable medical equipment company to make sure they respond in a timely manner if the insurance company has questions. Check in periodically with the regional Permobil rep so he/she can check on the manufacture and assembly process.
I'm sure there are other things to add to this list. I hope others will post their suggestion here or on the Permobil thread I started at: http://sci.rutgers.edu/forum/showthr...M300-Corpus-G3
All the best,
Last edited by gjnl; 11-26-2016 at 03:45 PM.
Does anybody have any experience with or opinion of the anterior tilt feature of the Permobil? I tried it out when I had the demo in my home. It supposedly helps with reaching for things and doing some work for short periods when you need to lean forward, like writing checks etc.. I can see it having benefit, especially since it saves the shoulders from having to pull yourself forward out of the power chair back to reach for something.
As a quad we would only want to use it in the lower ranges as once the seat tilts you too far forward you could slide out of position.
Also I am awaiting to hear from my DME rep whether it is a covered or noncovered option.
This from Mobility Management may answer some of your questions:
Anterior Tilt (F3/F5 Power Bases)An ATP & Clinician Best Pick of 2015:
Anterior tilt as a power seat function has had limited availability in the industry and is not currently coded under the PDAC coding system. Despite these things, anterior tilt can provide exceptional benefits to wheelchair users both functionally and physiologically. For some, just a small change in orientation anteriorly can effectively manage tone and abnormal reflexes, which can often interfere with function. In addition, small amounts of anterior tilt lowers front seat-to-floor height and can be the difference between getting under a table/desk or being limited by the lower extremities. Many power wheelchair users would be able to use anterior tilt to assist with functional reach, making the user independent with performing mobility-related ADLs including self-care, hygiene, cooking, cleaning, laundry and much more! It is amazing how much access is improved with just 20? of anterior tilt! Even further, there are individuals who need to transfer out of their power wheelchair, but just don’t have the strength to do so. The 45? stand-pivot transfer package is ideal to assist with this task — making transfers much easier and allowing them to be performed independently.
All the best,
my DME says no, permobil rep says yes
imagine if the DME takes my money for a "non-covered" item and keeps it
I've had a DME supplier try to pull this on me when I had to have a motor replaced on a power chair. They required payment at the time of order, then when Medicare covered the motor replacement, it took an eternity to get a refund from them. It can be tricky. Somehow, I don't think Medicare or your state insurance commission would look favorable on this double dipping practice, if you have to get them involved.
All the best,
Spoke to the government funding specialist at Permobil yesterday. He said that anterior tilt is not covered, powered leg rest extension is not (elevation is), upgrading to group 24 batteries should be, and aftermarket back should be as well.
I rarely use the seat elevator and when I do it is once a week at the bank and then on occasion when browsing an additional shelf or two higher at the library. But do these warrant laying out $3000 and more importantly, losing an inch of headroom in my Honda Odyssey which already has somewhat limited visibility due to the seat height of my C 300? My existing C 300 was able to be modified so the rear seat to floor height (17.5) was a full inch lower than the front seat to floor height. We all know that an inch makes a big difference in visibility and fitting under tables. My DME rep said that modification is no longer possible and that one should expect an 18 1/2 inch seat the floor height in the F3, if one is using the elevator. By not getting the elevator I can at least keep my windshield visibility the same.
I did check out my drivers position in the F3 and the visibility was not bad. But if I can lower it an inch it would be much better for driving comfort.
So I am leaning towards forgoing the seat elevator this time, but paying out-of-pocket for the anterior tilt, which I could see using on a regular basis when working in my home office and other circumstances when I need to forward reach and which currently are difficult because of the rear tilting of the dump angle required. Even if one goes completely horizontal before forward reaching it still requires effort to reach things sometimes.
Does anybody have anterior tilt or is anybody considering it?
just ordered a permobile f3 and it is covered by medicare. a few options on it are not
the raising seat option