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The Process

Getting Qualified for Insurance Coverage

Nothing worthwhile is easy, especially when it comes to navigating the world of insurance coverage, but we’re here to help! Many conditions qualify someone for a custom Complex Rehab power or manual wheelchair. We also offer less complex power and manual wheelchairs for those with less severe conditions. Once you’ve identified the qualifying diagnosis that best describes your medical condition, you’ll want to know more about the process of obtaining a power wheelchair through your insurance. Keep in mind that such a detailed customized process can sometimes take several months to complete. Here’s how it works:

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Intake & Eligibility:

You’ll contact one of our friendly Intake Coordinators and provide some information about yourself and your insurance provider. We’ll use this information to check your insurance eligibility to make sure that we are clear to work with your health plan.

Schedule & Evaluation:

We will schedule a meeting between you and one of our RESNA certified ATPs in order to take measurements to custom-fit your power or manual wheelchair to your dimensions and condition. Additionally, this visit will give us the chance to confirm that you’ll have room to use the power wheelchair within your living environment. To fit with your schedule and ours, this step may take 2 - 14 days.

Quote:

Our ATP will use the details of your in-home evaluation to select the power or manual wheelchair base and accessories that best fit your medical needs. We will submit this selection to one of our manufacturers to obtain a price quote. The quote and all the other evaluation documents will be compiled into a report that we submit to your doctor for approval. On average this step takes 1 – 3 business days.

Documentation:

Your doctor will receive our preliminary report, manufacturer’s quote, and documentation request. If your doctor agrees that the power or manual wheelchair is medically necessary, she will sign our forms and provide us with the requested documents. This step is a common cause of delay but calling your doctor’s office and reminding them of your need for a wheelchair will often solve the problem.

PAR:

Once your doctor completes the paperwork and faxes it back to us, we'll review everything to make sure it meets your insurance's coverage criteria. If no additional documentation is needed from your doctor or therapist, we'll submit your case to your insurance provider to initiate a Prior Authorization Request (PAR). This step is a common cause of delay in the process as your insurance provider may ask for additional information or may deny the request. Resolving these problems may take some time but we promise to fight for you! In most cases, a denial is only a temporary obstacle to overcome! And you’re always welcome to call your Case Manager for an update on your case progress.

Copay:

Certain insurances require their members to pay a portion of their medical services. If you have a copay, your case manager will contact you to inform you of your copay amount and discuss the different payment methods available. For your convenience, Freedom Mobility Center offers several different financing options. If you don’t have the funds to afford your copay, even on a small monthly payment plan, your Freedom Mobility case manager will advise you to call your health plan and discuss this with them. There are many additional coverage options for people who truly can’t afford their copay!

Order:

Your PAR has been approved! Once we have insurance authorization and copay arrangements have been settled, your equipment is ordered. This step can take 2-4 weeks depending upon the number of different manufacturers involved. Standard chairs already in stock can be delivered within days, whereas custom and/or more complex chairs requiring components from multiple manufactures will take longer.

Assemble:

We will receive the parts from the manufacturer, assemble your wheelchair, and then test it to make sure that everything is functioning properly. Less complex chairs take 1-2 business days. More complex chairs may take a week or longer. 

Schedule:

When everything’s in order and your power or manual wheelchair is ready to be delivered, our scheduling staff will call and schedule you on the next route to your area. Though scheduling may take some time to find a delivery date that works both for you and our delivery specialist, we are committed to reaching you as soon as possible!

Delivery & Training:

The best step of all. Your new complex rehab power or manual wheelchair will be delivered by one of our ATPs who will spend as much or as little time as you need to feel completely comfortable in operating your newly customized equipment.