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Thread: Abilities Expo - why I want to be rich

  1. #11
    Senior Member grommet's Avatar
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    Quote Originally Posted by RollPositive View Post
    No dont be jealous get one and lets roll! Sometimes with the DME reps they plant the negative "chairs are not being funded, we cant get approval etc"That puts us as feeling rejected and our orders are not going to get funded.

    Also if you have employee insurance you can talk to your HR there is a insurance liaison that can get funding approved.

    This happen to me I got declined and when I went to my employer they sent me to someone in HR that was able to get the order approved.

    She told me its on a case by case basis.

    I would work with the DME your insurances is with and go through the process and see how it goes.

    I was a long time Pride user and there chairs have just gotten terrible so made the switch to Permobil m300 then to a F3 never looking back Permobil is the brand!

    Come on you can do it!

    Do you ever go to LA Expo in March? I think its even bigger... we go its amazing for networking!
    Thank you for the support :-) Last night my girlfriend and I had a long talk about the Permobil and along with her encouragement the support I am getting from others like you, I am going to try. I talked to the Permobil rep and she said my last two chairs are that same category as the Permobil I want so I should be eligible. I'll try and make some phone calls this coming week and see. It feels like a pipe-dream and to avoid the insurance stress I am thinking about doing all I can to keep my current chair going but maybe I can try to make this happen. I keep thinking of all the bruises I won't have from leaning and falling trying to reach things if I had a better chair. That's why my girlfriend says it's worth it.

  2. #12
    Quote Originally Posted by grommet View Post
    Thank you for the support :-) Last night my girlfriend and I had a long talk about the Permobil and along with her encouragement the support I am getting from others like you, I am going to try. I talked to the Permobil rep and she said my last two chairs are that same category as the Permobil I want so I should be eligible. I'll try and make some phone calls this coming week and see. It feels like a pipe-dream and to avoid the insurance stress I am thinking about doing all I can to keep my current chair going but maybe I can try to make this happen. I keep thinking of all the bruises I won't have from leaning and falling trying to reach things if I had a better chair. That's why my girlfriend says it's worth it.
    Medicare requires that you go through certain steps in the process. Private insurance may not require the same steps, but going through them anyway can only serve to strengthen your case.

    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,
    GJ
    Last edited by gjnl; 11-26-2016 at 03:45 PM.

  3. #13
    Senior Member grommet's Avatar
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    Thanks GJ, that is great information. I need to read it a few more times. A bit of brain overload right now but I think you explained things simply and clearly. Thanks again :-)

  4. #14
    Quote Originally Posted by grommet View Post
    Thank you for the support :-) Last night my girlfriend and I had a long talk about the Permobil and along with her encouragement the support I am getting from others like you, I am going to try. I talked to the Permobil rep and she said my last two chairs are that same category as the Permobil I want so I should be eligible. I'll try and make some phone calls this coming week and see. It feels like a pipe-dream and to avoid the insurance stress I am thinking about doing all I can to keep my current chair going but maybe I can try to make this happen. I keep thinking of all the bruises I won't have from leaning and falling trying to reach things if I had a better chair. That's why my girlfriend says it's worth it.



    Good deal!!! Somethings I would do from the start is contact your DME and have the Permobil rep set up a demo on a Friday and leave the chair till Monday.

    It's important that manufactures and DMEs start making changes to how they start doing business.

    We are more savvy as consumers so long gone are the days of testing a chair on a smooth tile floor of a DME with the ATP rep walking alone side of us like we are going to take the chair and run!

    Nowadays we need to roll in our real life environments, home, school, grocery stores etc.

    If your a user of public transpiration you need to be picked up in a shuttle or cab, if you use subway or light rail you need to test it like someone that would test drive a car.

    I had mine for 4 days and each day was better then the last. I had a Permobil rep in Florida push back when someone tried to arrange a weekend demo but went above the rep and explained why these are needed so hoping they will set it as a best practice.

    Let me know if you have push back.

    Next let your DME ATP that writes the order to keep it positive and no negative dont tell us how chairs are not being funded...it just means they have to work harder to get it funded that is part of their job!

    Look at getting seat elevation its a big help and it is fund-able. Pride has a help sheet and just have your DME use it as a template for your F series. I think Pride has a 60% approval rate on elevated seating.

    But if your DME starts saying they dont fund when they do then its putting that negative out there!

    http://www.quantumrehab.com/pdf/self...t-height-1.pdf

    Dont forget to check out the new joystick its bluetooth to your smart phone and can use voice control though the joystick...

    http://www.permobilus.com/joystick-module.php

    So excited for you and keep us posted on how it's going

  5. #15
    grommet: Just a follow up so glad your on the way to getting a new chair and so glad I could help. Excited to hear how your demo goes please keep us posted!!

  6. #16
    Good luck with this, hope it works out.
    Several years ago I was able to get Medicare coverage for a used Permobile - it was a demonstration unit and had everything I needed and everything I didn't think I needed. It had the power vertical rise function which I found extremely useful for doing gravity transfers. However, it was all covered by Medicare except for that feature. I was told this in advance and agreed to cover that portion which was something like 2 or 3 thousand.
    Hope you can get that feature.

  7. #17
    Senior Member grommet's Avatar
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    Quote Originally Posted by triumph View Post
    Good luck with this, hope it works out.
    Several years ago I was able to get Medicare coverage for a used Permobile - it was a demonstration unit and had everything I needed and everything I didn't think I needed. It had the power vertical rise function which I found extremely useful for doing gravity transfers. However, it was all covered by Medicare except for that feature. I was told this in advance and agreed to cover that portion which was something like 2 or 3 thousand.
    Hope you can get that feature.
    Hi. I never heard of insurance paying for a used/demo chair. That would be cool.

    I am getting my demo of the Permobil F3 this Friday. I guess we'll do the paperwork then too. My doctor sent the prescription last week and Rollpositive has helped me so much, thank you :-)

    I always imagine someone at the insurance provider deciding my fate while drinking a cup of coffee and dropping cake crumbs on the desk. They click this box or the other and I get something or I get nothing. This might sound like negative thinking it's just that over the years I've had some strange approvals and disapprovals. Like when I asked for new seat back fabric and they said no, not covered ($40). They then offered me a new seat back ($600). WTF?! I had to accept the back just for the fabric. I am sure there are good people doing the insurance work and it's just a complex system but I am totally confused by it and feel at it's mercy. I think that's where knowledge is power.

    Well I've been looking online at the F3 like it's porn. Let's see if I get the girl ;-)

  8. #18
    Grommet: We just wanted to wish you good luck this weekend with your Permobil F3 demo!!

    Its going to be nice seeing what the chair can do for you to cover come your daily challenges.

    Hoping the weather breaks and clears up for you.

    Let us know how it went!




  9. #19
    Senior Member grommet's Avatar
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    That animation is cracking me up :-) They'll be here in a couple of hours. The rain has let up, now the forecast says rain tomorrow. Maybe I will be able to get out.

  10. #20
    Senior Member grommet's Avatar
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    Update.

    I tried the Permobil F3 this last weekend. It's really impressive. So quiet in every way. Very smooth too. My girlfriend commented that it was good looking. The DME was wonderful, such a nice person.

    The set up for the demo chair didn't fit me well enough for me to spend all the time in the chair I wanted but I do want the chair, I can see the changes we can make so it will fit. My current chair (Invacare TDX-SP) is very comfortable so speaking with the DME he says he has all those specs and some ideas for changing the seat back. One step at time.

    If anyone has the chance to try an F3 I would recommend taking the opportunity.

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