What is a Mobility Evaluation - Steps To Getting A Power Wheelchair Through Insurance
Key Takeaways:
- A mobility evaluation is crucial for determining medical necessity and securing insurance coverage for a power wheelchair.
- The evaluation includes both a clinical assessment by a healthcare professional and an insurance-focused interview with a mobility specialist at UniversalMed Supply or a similar conversation with the DME company of your choice.
- If your physician needs guidance on the forms and documentation that need to be completed during a mobility evaluation, please let them know they can give us a call at 866.864.6332.
- Proper documentation and coordination with your doctor and insurance provider are essential for a smooth process.
- Working with experienced mobility specialists to help you navigate through the process can significantly increase your chances of obtaining insurance approval.
- The process involves multiple steps, from initial contact and insurance verification to device selection and delivery.
Introduction
Navigating the process of obtaining a power wheelchair through insurance can feel overwhelming. One crucial step in this journey is the mobility evaluation. This assessment plays a pivotal role in determining your eligibility, ensuring you receive the right equipment for your needs, and getting approval from your insurance for coverage. In this post, we break down what a mobility evaluation is, why it is essential, and how it helps you secure insurance coverage.
Understanding the Mobility Evaluation
A mobility evaluation, which may also be known as a seating evaluation, functional seating assessment, mobility examination, wheelchair seating and mobility assessment, or a face-to-face examination for a power wheelchair, is a comprehensive assessment designed to determine an individual’s ability to move and perform daily activities independently. It serves as a foundation for understanding your specific mobility needs and the type of equipment that can best support you. This process often involves two key components:
Related Blog Post: What Types Of Power Wheelchairs Are Covered By Health Insurance?
Pre-Evaluation Phone Interview
- We begin with a pre-evaluation phone interview with you to learn about your diagnosis and potential electric wheelchair needs. This step allows us to provide tailored guidance to your doctor’s office, ensuring their documentation is aligned with insurance requirements.
Clinical Mobility Evaluation
- This component involves a thorough physical assessment conducted by a certified healthcare professional at your doctor’s office.
- The evaluation aims to identify limitations in movement, potential risks for falls, and other functional mobility issues.
- Key factors assessed include:
■ Physical abilities: Range of motion, endurance, balance, strength, and coordination.
■ Environmental factors: Analysis of your living conditions for potential
hazards and accessibility.
■ Medical history: Review of past injuries, medical conditions, and
medications.
■ Mental or cognitive assessment: Patient’s willingness and ability to operate the mobility device independently or the need for caregiver involvement in the operation of the device - The goal is to create a personalized care plan that supports your mobility needs and promotes independence.
- A completed evaluation helps to determine the type of mobility device that is medically necessary. For an understanding of what type of power mobility device you may qualify for check out this blog post.
Why is a Mobility Evaluation Important?
- Medical Necessity: Insurance companies require documentation of medical necessity before approving coverage for a power wheelchair. A mobility evaluation provides this documentation, demonstrating that the equipment is essential for your health and well-being.
- Personalized Solutions: The evaluation ensures that you receive the right type of power wheelchair to meet your specific needs. It considers your physical and mental abilities, living environment, and daily activities to recommend the most suitable device.
- Safety and Independence: By identifying potential risks and limitations, the evaluation helps to prevent falls and promote independence. It allows healthcare providers to develop a care plan that maximizes your mobility and quality of life.
- Streamlining the Insurance Process: By obtaining the proper documentation from your physician, and by having the correct mobility device prescribed, you greatly increase the chances of insurance covering the device
Steps to Getting a Power Wheelchair Through Insurance:
1. Contact Our Mobility Specialists:
Begin your journey by contacting our experienced mobility specialists. Call us at 888.364.5897, Monday through Friday, from 9:00 AM to 5:00 PM CST. Our team will provide an initial understanding of our process, the insurance companies we work with, and the range of power mobility products we offer. We will gather a few essential details and if you choose to proceed, we will start the the process of verifying your insurance coverage.
2. Schedule Your Mobility Evaluation:
Following successful insurance verification, we will collaborate with you and your physician to schedule a comprehensive mobility evaluation. This step is where the medical necessity for a power wheelchair is formally documented, and the proper device is determined.
3. Documenting Medical Necessity:
We’ll partner with you and your doctor before and after your mobility evaluation to gather all the information needed for insurance approval of a power mobility device. Your doctor makes the final decision on medical necessity, and while there’s a chance they might not approve it, we’ll make the paperwork process as easy as possible if they do. We’ll coordinate collecting medical records, evaluation results, and any other required insurance documents, aiming to make the process smooth and increase your chances of funding.
4. Device Selection:
Based on the results of your mobility evaluation, our team will guide you through the features and benefits of the power mobility devices that align with your medical needs and insurance coverage. We’ll help you select a device that best meets your individual requirements and lifestyle.
5. Insurance Authorization:
Once your device selection is finalized, we will submit the comprehensive results of your mobility evaluation, along with all other required documentation, to your insurance provider for prior authorization. Our streamlined process and expertise has resulted in a nearly 90% approval rate, giving you confidence in our ability to secure funding for your power wheelchair.
6. Delivery:
Upon receiving authorization approval from your insurance company, we will contact you to arrange a convenient delivery time. Our trained technicians will deliver your power wheelchair and provide a thorough walkthrough of its features and functions, ensuring your safety and comfort.
Conclusion:
A mobility evaluation is a crucial step in obtaining a power wheelchair through insurance. By understanding the process and working with qualified professionals, you can navigate the system with greater confidence and secure the equipment you need to maintain your independence and quality of life.
If you or a loved one is considering a power wheelchair, contact UniversalMed Supply today at 888.364.5897 . You can also submit a contact request for one of our team members to reach out to you here:
