News
Tip From The Trenches
Date Published: March 21 2013
Q: My referring doctor used DMEevalumate for an evaluation and the program selected a power wheelchair for the patient. The doctor (or patient) only wants a scooter. What should I do?
A: DMEevalumate.com does not guarantee requested or preferred equipment for patients. The goal is to accurately determine who qualifies for a power wheelchair or scooter, as per Medicare coverage criteria, and to correctly document medical justification that will receive Prior Authorization approvals and pass Audits.
DMEevalumate.com acts as an intermediary between the physician and the Medicare coverage criteria, to determine what PMD equipment, if any, the patient qualifies for. In this case, it has been determined that the patient qualifies for a power wheelchair and therefore that is the PMD that will receive Prior Authorization approval. It is very likely that the patient will be denied if a request for a scooter is submitted.
DMEevalumate.com offers one-on-one consultation regarding PMD and Respiratory claims. If the physician or DME provider would like to receive a call from a DMEevalumate Medicare coverage criteria expert, send an email to info@dmeevalumate.com and let us know about the recommendation. Documentation should be faxed to 800-986-9368.
This information is brought to you by DMEevalumate.com Tips from the Trenches, in response to FAQs from our customers. For more information, contact us at info@DMEevalumate.com
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