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Thread: I want a roho prodigy

  1. #1

    I want a roho prodigy

    I want a roho prodigy matress. problem is 4 medicare contracted supplies do not carry roho products. what do i do.
    Wish I didn't know now what I didn't know then.
    Bob Seger

  2. #2
    Quote Originally Posted by tvot View Post
    I want a roho prodigy matress. problem is 4 medicare contracted supplies do not carry roho products. what do i do.
    Maybe your best shot is getting a physician, possibly with the input of a physical therapist, to recommendation, write a prescription and make a good medical case that the Roho mattress (and no other) is what is required for your situation. But, Medicare is pretty rigid and going out of network to a non contracted supplier is an uphill struggle.

    What mattress options are offered by the 4 Medicare suppliers you have to work through?

  3. #3
    Are you using regular Medicare, or a Medicare HMO (which restricts your DME options)??

    Find a dealer: https://permobilus.com/product/rohop...verlay-system/

    Here is the decision tree for Medicare payment for this product. You do need a prescription that entails these issues for Medicare payment: https://www.rehabmart.com/pdfs/medic..._home_care.pdf

    Tons of on-line dealers, here are just a few:

    https://www.rehabmart.com/product/pr...y-roho-60.html

    http://www.etennurologicalsupplies.c...prodigysys.htm

    https://www.usmedicalmobility.com/cr...uctId=19641480

    https://www.hutchinsonmedical.com/th...ductid=4652546

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  4. #4
    Quote Originally Posted by SCI-Nurse View Post
    Are you using regular Medicare, or a Medicare HMO (which restricts your DME options)??

    Find a dealer: https://permobilus.com/product/rohop...verlay-system/

    Here is the decision tree for Medicare payment for this product. You do need a prescription that entails these issues for Medicare payment: https://www.rehabmart.com/pdfs/medic..._home_care.pdf

    Tons of on-line dealers, here are just a few:

    https://www.rehabmart.com/product/pr...y-roho-60.html

    http://www.etennurologicalsupplies.c...prodigysys.htm

    https://www.usmedicalmobility.com/cr...uctId=19641480

    https://www.hutchinsonmedical.com/th...ductid=4652546

    (KLD)
    As I understand Medicare, you cannot go to a non Medicare provider, (do these only line providers accept bill Medicare and accept Medicare pay as payment in full), buy the mattress, and then expect reimbursement. Been there...done that. lost 4 rounds of appeal on a piece of durable medical equipment.

  5. #5
    Quote Originally Posted by gjnl View Post
    As I understand Medicare, you cannot go to a non Medicare provider, (do these only line providers accept bill Medicare and accept Medicare pay as payment in full), buy the mattress, and then expect reimbursement. Been there...done that. lost 4 rounds of appeal on a piece of durable medical equipment.
    You are correct. The DME companies I posted all will take a prescription and bill Medicare as long as the prescription (actually, letter of medical necessity) includes the Medicare indications listed. There are many others that will as well. If tvot has a Medicare HMO though, this may severely limit the DME companies he can use. One of the reasons I did not sign up for a Medicare HMO, personally!


    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  6. #6
    Quote Originally Posted by gjnl View Post
    Maybe your best shot is getting a physician, possibly with the input of a physical therapist, to recommendation, write a prescription and make a good medical case that the Roho mattress (and no other) is what is required for your situation. But, Medicare is pretty rigid and going out of network to a non contracted supplier is an uphill struggle.

    What mattress options are offered by the 4 Medicare suppliers you have to work through?
    well a therapist started helping today. she got as far as i did. my opinion is they don't sell roho because of a low profit margin. just let me say this. it was so much easier years ago and it will be a cold day in hell before i get a different mattress. DON'T MESS WITH SUCCESS!
    Wish I didn't know now what I didn't know then.
    Bob Seger

  7. #7
    tvot, are you restricted to those companies by your insurance? See discussion above.

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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