If you are recovering from a stroke or other type of injury that requires you to rent a wheelchair to help with your mobility, it's important to know what it takes to get this type of medical equipment covered by insurance. Here are three things to know when it comes to insurance and wheelchair rentals.
The Wheelchair Is Medically Necessary
No matter what kind of insurance you have, even if it's Medicare, they will need to know why you need a wheelchair. They will need to know if it is medically necessary for you to have one. They will also need to know the diagnosis you have been given by your doctor that would deem it necessary for you to use a wheelchair. This information is important because they need to make sure you are not needing one if it is not medically necessary. Most insurance companies require a prescription from your doctor before they will cover wheelchair rentals.
Your DME Provider Should Be In Network
The companies that provide wheelchairs and other types of medical equipment are known as durable medical equipment (DME) providers. Insurance plans usually have a network of providers that they are contracted with. This includes DME providers.
Before going ahead and approving your wheelchair rental, your insurance company will need to make sure the DME company you are using is in your insurance plan's network. If the DME company is not in network, you will end up paying more out of your own pocket. If you have Medicare, they will cover your wheelchair rental only if your doctor and DME provider is enrolled with them.
Your Wheelchair Rental May Require Prior Authorization
When it comes to renting medical equipment, most insurance companies will require a prior authorization. This includes wheelchairs. The prior authorization process is normally handled by the DME provider and the insurance company. As part of the authorization process, the insurance company will need to verify that the wheelchair is medically necessary. Before getting the wheelchair, it's always a good practice to call the insurance company to check the status of the prior authorization. If the authorization does not get approved, your doctor or the DME company can appeal the decision.
Once your insurance company has verified why you need the wheelchair, you know the DME company you are going through to get the wheelchair is in network, and the prior authorization has been approved, you will be well on your way to using your wheelchair while having a peace a mind. For more information, talk to a professional like Falk Surgical Supplies.