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Thread: Buying Chair with Insurance, but without DME

  1. #1
    Senior Member
    Join Date
    Apr 2011
    Location
    Southern Maryland
    Posts
    118

    Buying Chair with Insurance, but without DME

    Does anyone have experience ordering a chair without DME intervention, but still submitting to insurance? I seem to be particularly hard on my chairs since I see others who can last much longer between chairs, but it is a struggle to get to 5 years without replacing each component (casters, cushions, wheels) at least twice. I'm coming up on the 5 year mark since I last had insurance pay for a chair, though only 3 years since my last new one. I want to buy a new one and use insurance to pay a piece, but do not want to work through a DME in Maryland (or metro-DC area).

    I looked at the ordering forms on sites like Bike-On or Sportaid and am able to fill in all the pieces. I have so far worked with 3 different DMEs (Chesapeake Rehab (now Numotion), MED Inc., and Global Repair Group (GRG)) and each has been worse than the last. I've only had 3 chairs since being paralyzed in 2010. First was direct out of rehab, second was 5 years later, and the third was courtesy of Southwest Airlines after my chair came up from cargo on three wheels. Each time they have either ordered incorrect parts or sizes or simply failed to assemble it correctly. All have required multiple home visits and repeated arguments until the correct equipment is delivered and assembled correctly.

    On the bright side of the horrible service I've received, I am capable of fully tearing my chair down to nothing but the frame and reassembling it (which I had to do with GRG). I am confident that if I were to order the individual pieces (or order from an online dealer who assembles parts of it) that I would be able to assemble it correctly.

    The part i really need help with is submitting something to insurance without paying the overhead of a DME. I am capable to submitting insurance claims and my insurance is pretty good, but I'm not sure the rules of the road when it comes to wheelchair equipment. For almost everything else, I've just paid out of pocket to avoid working with another DME.

    Any experience or guidance on these matters would be greatly appreciated!

    Thanks!
    Shawn

  2. #2
    Shawn,
    its straight forward. i did my last 2 this way just to save the headache.
    1. spec and order your chair from an online dealer
    2. be sure you have a rx from your doc with a good lmn.
    3. download a self claim form
    4. submit the claim form with your paid invoice, rx and lmn
    every ins is different mine was easy but i helped another customer of mine a few months ago and his ins was a bear to work with but did get it handled.

    fax everything in then followup every week until its done
    Bike-on.com rep
    John@bike-on.com
    c4/5 inc funtioning c6. 28 yrs post.
    sponsored handcycle racer

  3. #3
    Senior Member
    Join Date
    Apr 2011
    Location
    Southern Maryland
    Posts
    118
    Excellent! Thank you for the insight. That is a lot upfront, but I think it will save me in the end.

  4. #4
    also, your ins will likely require codes on the invoice. check with them so you can have whatever is needed added to your invoice.
    no problem, good luck.
    Quote Originally Posted by ToastGuard View Post
    Excellent! Thank you for the insight. That is a lot upfront, but I think it will save me in the end.
    Bike-on.com rep
    John@bike-on.com
    c4/5 inc funtioning c6. 28 yrs post.
    sponsored handcycle racer

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