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Thread: Medical Necessity Form - Any way to get one quickly?

  1. #1

    Question Medical Necessity Form - Any way to get one quickly?

    Hello, I am a right leg amputee, and have been in a wheelchair for a long time (since 1996).
    I have a some money left in my medical "cafeteria plan" that I have to use this year or I lose it.
    My good wheelchair has recently broke and I would like to get a new one.
    My insurance says that they will cover one if I have a "Medical Necessity Form" (I still have to pay part of it, which is why I would spend my money).
    Does anyone have any tips on how I can quickly get a Medical Necessity Form for a wheelchair?
    I can get one at a "Mobility clinic", but so far all the clinics I have contacted cannot see me until next year, which is too late.
    Oh if it is useful, I live in Georgia, USA
    Thank You.

  2. #2
    Call some "walk in" clinics until you find one with a real doctor who can see you today.
    I have had periodic paralysis all my life. I lost my ability to walk in 2011 beginning with a spinal block, which was used for a hip fracture caused by periodic paralysis.

  3. #3
    Not likely. The letter is usually a detailed description of the equipment you require, with justification for all the features and options. It is normally written by the therapist who does your equipment evaluation, who then signs it, and sends it to your physician who signs it as a prescription, and it is then submitted by the vendor to the insurance company. Getting all that done over the holidays will be very difficult.

    (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
    The OP wants to know how to get the form if there is one filled out.
    I have had periodic paralysis all my life. I lost my ability to walk in 2011 beginning with a spinal block, which was used for a hip fracture caused by periodic paralysis.

  5. #5
    Quote Originally Posted by nonoise View Post
    The OP wants to know how to get the form if there is one filled out.

    And what I described is the process. There is no standard pre-filled out Letter of Medical Necessity. It has to be highly individualized.

    (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
    Thanks. I do need them to fill out a form, so I guess I am out of luck for this year. Dang.

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