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Thread: BCBS coverage of titanium chair

  1. #31
    Quote Originally Posted by Art454 View Post
    Tom already did. Read it.
    I am sorry, but I just reviewed t8burst's posts and can't find where he shared his letter. If I missed it, perhaps you could point me to the link for that post?

    I am paralyzed, 30 years now. I do not want a power chair, and I would fight anyone who tries to force one on me. That would greatly inhibit my life and overall mobility. I am very glad that you found a solution to your shoulder pain, but everyone is different. There is no one size fits all solution.

  2. #32
    Senior Member
    Join Date
    May 2010
    Location
    Southern California
    Posts
    436
    Funklab-
    Before you spring for titanium push rims investigate rib grips. They give a much easier push, requiring less energy. They are very easy on hands as well as shoulders. I was hesitant to get them 18 months ago, but I tried it and am now hooked. Occasionally they have sales where a pair goes for only $99 and one is on right now.

    https://ribgrips.com/

  3. #33
    I'm not looking to get any fancy rims. I actually quite like aluminum hand rims, it's just after a couple years mine now blacken the heck out of my hands randomly (I can't see any rhyme or reason as to why it does some days and doesn't other days, maybe it's worse when it's humid outside). I'm just hoping titanium won't oxidize like aluminum (I'm assuming that's what's happening) and make my hands look like I've been playing with coal after pushing a few hundred yards.

  4. #34
    Quote Originally Posted by funklab View Post
    I'm not looking to get any fancy rims. I actually quite like aluminum hand rims, it's just after a couple years mine now blacken the heck out of my hands randomly (I can't see any rhyme or reason as to why it does some days and doesn't other days, maybe it's worse when it's humid outside). I'm just hoping titanium won't oxidize like aluminum (I'm assuming that's what's happening) and make my hands look like I've been playing with coal after pushing a few hundred yards.
    I love my Ti hand rims. With all the scraping they get, the material smooths out scratches and gouges. If BCBS won't cover them on my new wheels, I'll probably transfer over the ones I have.

    Also, you'll love this, but I ditched NuMotion because their customer service has been beyond bad. I don't think they want to sell me a chair. I called your favorite company, National Seating and Mobility. The guy I met with has been a chair almost as long as I, and was very helpful. He and the local store have a very can-do attitude about getting stuff covered and seem willing to advocate for me. He showed me their strategy for justifying things to BCBS and said they have a decent success rate getting Ti covered.

  5. #35
    Just a point of reference- I have United Healthcare and was able to get a Aero Z with "titanium frame upgrade" (Numotion) - it uses K0005 code but is really a full ZR when it arrives.

    I had to buy clothing guards and new Spinergy rims from DMEHub, rest covered by UNH.

    That said, next time I will max out my FSA and order from DMEHub and have my chair in two weeks, not 9 months + doctor, PT, repair man, etc appointments to get a new chair approved. The process is horrible.

  6. #36
    Well unless anyone has some other suggestions it looks like I'm going to have to pony up the $1500 for the upgrade. BCBS denied it even after my doc sent an appeal letter. I'll give them one last call and make it clear that I am quite CERTAIN that my medical costs will GREATLY exceed the $1500 they won't pay now for the upgrade.

    Of course I'm going to do the upgrade, but I have a feeling reaching that deep into my wallet is going to cause me such significant shoulder pain I'm going to require near constant physical therapy for my shoulders and a lot of specialist visits right up until I leave the company and change insurance companies.

  7. #37
    Did you request that your appeal be reviewed by a physiatrist? You have the right to request the specialty of the physician reviewing the appeal. Might be worth a try.

    (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.

  8. #38
    Quote Originally Posted by SCI-Nurse View Post
    Did you request that your appeal be reviewed by a physiatrist? You have the right to request the specialty of the physician reviewing the appeal. Might be worth a try.

    (KLD)
    Sounds like it's worth a shot. I guess I just say that to BCBS when I call them up?

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