If you are the owner of a motorized wheelchair, you may be wondering if you need to purchase insurance for your equipment. This article discusses the different types of coverage for this type of equipment and what you can do to get covered. Whether you are using your wheelchair in your home or in a medical facility, there are certain requirements you need to meet.
Reimbursement for the wheelchair codes
The Center for Medicare and Medicaid Services (CMS) defines a wheelchair as a portable, four-wheeled mobility device that is operated by a user using either arms or hands.
A power wheelchair is defined as a mobility device that is battery-powered and powered by an electrical motor. It is intended for individuals with sufficient upper-extremity and trunk function to move on their own.
In order to qualify for reimbursement for a wheelchair, it is considered medically necessary. It must meet the MAC criteria. Some of the factors that determine whether a wheelchair is medically necessary include:
the type of disability, whether or not the member is in a medically stable condition, the member’s level of mobility, the severity of the disability, the extent to which the member can perform activities of daily living with the use of a wheelchair, and the cost.
Reimbursement for a power wheelchair is usually not limited to the power itself, but includes the labor to install and assemble it, along with the support services.
If a wheelchair is rented for a period of time, the total payment is not more than the allowance for the rental. If the wheelchair is purchased by the member, he or she is responsible for payment. This payment includes the labor to assemble, setup, and use the wheelchair.
To qualify for reimbursement for the wheelchair codes, a physician’s order must be submitted and received within 45 days of the face-to-face examination. When the order is received, the supplier must provide detailed records on all repairs made. He or she must also explain the reason for any part replaced, and the time it took to return the wheelchair to its original functionality.
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Non-compliance with treatment can result in denial of coverage
In a nutshell, power operated vehicles, or POVs as they are more often referred to, are battery powered non-highway motorized transportation systems designed for people with impairments in their ability to ambulate. These may be for indoor use or outdoors, and range from three to four wheels in size.
Power operated devices are not the only type of assistive devices covered by Medicare. Some other notable examples include: scooters, pedal driven tricycles, and Segway personal transporters. Each company has its own set of criteria to consider when deciding if it will cover your mobility device.
The most important criterion is whether the item is medically necessary. A power operated device is considered to be of the highest medical necessity if the individual’s health condition is sufficiently serious enough to warrant the purchase of such a device. Despite this, coverage is not a given. This is due to several reasons, including: a lack of funding, a skewed formulary, and the presence of a preexisting condition.
It is important to note that in order to be considered as a medical necessity, a power powered vehicle must meet basic coverage criteria. For example, it must meet the PDAC Product Classification List, and the Center for Medicare and Medicaid Services (CMS) must approve it.
Rental of a wheelchair is medically necessary
If you’re a Medicare beneficiary, you may be interested in the fact that you may be able to get reimbursed for the rental of a motorized wheelchair. Depending on the design of your benefit, this type of device may or may not be covered.
Before you can receive reimbursement for your motorized wheelchair, you will need to meet certain requirements. Generally, your provider must be authorized to provide medical equipment. You will also need to have a doctor’s order if you’re looking for a new wheelchair. This particular policy outlines the details, so be sure to read it carefully.
The most important part of this particular program is that you must be able to use the device. To qualify, you must be able to use your wheelchair inside or outside your home. It’s also considered a good idea to have a documented record of how often and in what condition you use your wheelchair.
Aside from providing coverage for the cost of the wheelchair itself, you may be eligible to receive coverage for other related services. This includes setup, delivery, and ongoing assistance with the use of the device.
Some other items that you may be eligible to receive are accessories such as seat and handle covers, footrests, and grips. In some cases, you might be able to receive reimbursement for labor charges for assembly and repair.
Finally, the most important part of this policy is that you may be eligible for reimbursement. This is the most basic form of payment for a wheelchair, but it can vary depending on the type of device you choose. Hopefully, you’re now prepared to take full advantage of this benefit.
Maintenance and repairs
If you are the owner of a motorised wheelchair, then it is important that you have a thorough understanding of how to maintain and repair your device. Not taking care of your mobility device can result in costly repairs down the road.
Keeping your wheelchair in good condition helps ensure that you can get around easily and comfortably. You should also take it to a reputable service provider for regular maintenance.
To determine whether your chair requires a repair, check for loose parts. Loose nuts or bolts can cause damage, so tighten them using a wrench or screwdriver.
Wheelchairs are different from other types of mobility equipment, so you should make sure that you have the right tools. These include a tire patch kit, lubrication, Allen wrenches, and combination wrenches.
When your mobility equipment is not in use, store it indoors. Do not leave it in the sun or in a high-humidity area.
Inspect the wheels, suspension system, and seat cushions. If they are worn, replace them. Also, replace add-ons such as covers and cushions.
The head supports, lap belt, and pelvic belt should all be in good condition. If they are not, you will have to make adjustments to them.
Check your wheelchair for signs of wear, such as cracks, loose or corroded connections, and broken bearings. If you hear a rattling noise, or your wheelchair does not move properly, it may be time to take it in for repair.
Regularly clean your wheelchair with a damp cloth. This will help prevent dust from getting into the seat and electronics.
Make sure that your wheel locks are working properly. Using a belt will help keep you from sliding forward on the seat.
TriCenturion wheelchair insurance
TriCenturion is a regional durable medical equipment program safeguard contractor for 10 northeastern states. In addition to providing a quality assurance solution for Medicare and Medicaid beneficiaries, the aptly named firm also provides benefit integrity functions for Medicare Part A in Florida.
Currently, TriCenturion has a five-year $44 million contract with the Centers for Medicare and Medicaid Services (CMS), and is a leading provider of motorized wheelchair insurance in the U.S.
Having been involved in the field for decades, TriCenturion expertise is second to none. Whether your needs involve a new or refurbished wheelchair, a mobility scooter, or a stairway lift, TriCenturion can help. For information on coverage, visit TriCenturion website.
TriCenturion has a helpful FAQ document on its website. To get the best motorized wheelchair insurance deal for your buck, you will need to be prepared to do some legwork. One way to do this is to visit the TriCenturion website and take a quiz to find out which states have the most favorable coverage rates.
Fortunately, if you live in New York, New Jersey, or Connecticut, you will also be able to enjoy the benefits of the tristate’s best med-pay rates.
Thankfully, TriCenturion has a large pool of qualified and credentialed physicians and allied health professionals who can provide the care and guidance you need. Among the company’s many offerings, TriCenturion offers Medicare Durable Medical Equipment (DME) and Medicaid Durable Medical Equipment (DME) insurance, and can help you find the right insurance plan for you.
Whether or not you are a Medicare beneficiary, a visit to TriCenturion website will be an enjoyable and informative experience. Lastly, TriCenturion website also features a comprehensive list of vetted DME providers and manufacturers.
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