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Thread: Denied for my electric chair

  1. #1
    Senior Member GoTWHeeLs's Avatar
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    Question Denied for my electric chair

    I just found out that I was denied by medicaid for my electric chair. The way my DME explained it was in there thoughts they dont care if I leave the house or not. They also expect people to assist with the things I have a hard time with, like inclines and declines. WTF is this BS? What can I do now?
    Say what you mean and mean what you say because those who mind dont matter and those who matter dont mind.

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  2. #2
    Banned adi chicago's Avatar
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    i had the same problem 3 years ago.i bought a used one after they came to ask me their stupid questions .good luck my friend.
    • Dum spiro, spero.
      • Translation: "As long as I breathe, I hope."

  3. #3
    Get the local news station to do a piece on you
    send a notice to you congress person

    Go public..
    Rick Brauer or just call me - Mr B

    http://www.riseadventures.org

  4. #4
    Do you have a manual chair? If yes, was it paid for by Medicaid, and when?

    In writing up the letter of need to justify a powerchair, what was included? Did you get evaluated by a PT and/or O.T. who wrote it?

    If Medicaid paid for your manual, and it has been less than 5 years, but your medical/physical needs have changed, requiring a power chair, was that specified?

    Hard to know what process you took regarding getting the power chair approved, and what your specific needs are, from the little info you provided.

    You can re-submit to Medicaid, with a better/more detailed letter. There should also be an appeal process.

  5. #5
    Senior Member WheelieMike's Avatar
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    Appeal! They are in the business to save money first and help their clients last, with many other factors in between. They are probably hoping you don't know any better and will take their first answer.

  6. #6
    Banned adi chicago's Avatar
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    i dont know about gotwheels but i had to pay for both of my chairs ...i paid cash after my injury affected my credit.the manual was $1100 and the powerd one $4500.
    • Dum spiro, spero.
      • Translation: "As long as I breathe, I hope."

  7. #7
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    How did you go about requesting this chair? Your PT shoudl know all the ins and outs of requesting a certain type of chair, and what to write in the letter. If you didn;t go that route, look into that. (Or if you already knew and did that, feel free to ignore this ..... or as they say on late bills "If already paid, please disregard this notice".
    T7-8 since Feb 2005

  8. #8
    Senior Member GoTWHeeLs's Avatar
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    Quote Originally Posted by chick
    Do you have a manual chair? If yes, was it paid for by Medicaid, and when?
    Yes, about a year ago. I had no idea I was gonna have this kinda trouble getting around.

    In writing up the letter of need to justify a powerchair, what was included? Did you get evaluated by a PT and/or O.T. who wrote it?[/quote]Everything I need it for, it stated that it would approve my MRDA(daily living). PT, OT, and my doctor all participated in the draft that was sent to medicaid.

    If Medicaid paid for your manual, and it has been less than 5 years, but your medical/physical needs have changed, requiring a power chair, was that specified? [/quote]Yes

    Hard to know what process you took regarding getting the power chair approved, and what your specific needs are, from the little info you provided.

    You can re-submit to Medicaid, with a better/more detailed letter. There should also be an appeal process.[/quote]



    How do I post several quotes?
    Say what you mean and mean what you say because those who mind dont matter and those who matter dont mind.

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  9. #9
    I remember reading in the NSCIA newsletter about 2 years ago that 75% of DME requests are denied by the carrier and that 75 %of all appeals are won. That has stuck with me ever since. Appeal, appeal, appeal.

    It's a numbers game for them. They know the odds are good that you will go away or die before they actually have to spend the money if they stall long enough with all this paperwork.

    I'm always a fan of harnessing public opinion through the media. That's a great idea too.

    Good luck.
    My blog: Living Life at Butt Level

    Ignite Phoenix #9 - Wheelchairs and Wisdom: Living Life at Butt Level

    "I will not die an unlived life. I will not live in fear of falling or catching fire. I choose to inhabit my days, to allow my living to open me, to make me less afraid, more accessible, to loosen my heart until it becomes a wing, a torch, a promise. I choose to risk my significance; to live so that which comes to me as seed goes to the next as blossom and that which comes to me as blossom, goes on as fruit."

    Dawna Markova Author of Open Mind.

  10. #10
    They deny 70% of first requests, only 35% of those people denied will appeal. Make sure you're one of them, they're counting on you giving up.

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