5 Things to Know as You Start the New CRT Equipment Process

When it’s time to get new complex rehabilitation technology (CRT) equipment, the process can feel overwhelming. Even if you’ve been through the experience before, it’s easy to underestimate the number of steps, specialists and approvals involved. 

The good news is that with a little preparation and forethought — including knowing how often your insurance carrier allows you to get new equipment — you can help make the process a little smoother. Here are five key things to know as you start the journey toward new equipment. 

Know Your Team—and Their Roles

When the new equipment process seems overwhelming, it’s important to remember that you’re not in this alone. Your care team includes your physician or physiatrist, occupational or physical therapists and your Assistive Technology Professional (ATP). Each member of the team plays an important role in evaluating your mobility needs, providing needed documentation and documenting medical necessity, among other things. Many insurance carriers allow for new complex wheelchairs around every five years and may consider replacement around five years for other types of CRT equipment, so it’s important understand what your health plan covers. Work with your CRT supplier or therapist to schedule a seating evaluation as that time nears. Learn more about what to expect at your evaluation.

Plan Ahead for Prior Authorization

It’s no secret that prior authorization takes time. When it comes to new equipment, you often need to submit several documents and a variety of information to your insurance carrier for approval before your CRT supplier can order your new equipment. These often include: 

• A prescription for CRT equipment,
• A seating evaluation,
• An equipment estimate, and 
• A Letter of Medical Necessity.

Take the time to become familiar with your insurance carrier’s requirements for prior authorization for new equipment. Your CRT provider will take the lead on collecting the needed documentation, but you can play an active role and help streamline the process by understanding what is required and who to reach out to if something is missing, such as a prescription or Letter of Medical Necessity. Learn more about prior authorization. 

Understand the Timeline

The new equipment process takes time and patience. Since several steps must be completed and CRT orders can be very complex, it often takes months for new equipment to be approved, ordered, assembled and delivered. Timelines may differ depending on your insurance carrier and other factors, but your CRT supplier and team should be able to provide you with a more detailed timeline for your order. Learn more about the general timeline at NSM. 

Know Your Funding Options—and Advocate for Yourself Along the Way.

Insurance coverage can vary widely, and not every piece of equipment or accessory may be covered. Have a plan for how to cover out-of-pocket costs or research additional funding options such as secondary insurance, grants or other options. If your insurance carrier denies your prior authorization, work with your care team to prove medical necessity — which often means submitting additional documentation and waiting for approval. If you believe a component is medically necessary for your independence and quality of life, advocate for yourself and work with your care team to make your case appropriately.

Stay in Touch with Your ATP

Your CRT provider plays a valuable role in keeping your equipment up to date and working optimally. If you notice a problem, report it to your CRT supplier as soon as possible. Keep track of maintenance that has been performed on your equipment and strive to perform small tasks regularly—like cleaning your chair and caring for the casters—to extend the life of your equipment. If you notice any issues with your equipment, it’s important to check them out before they become bigger problems.

Navigating the new equipment process doesn’t have to be stressful! Seek to understand the process and educate yourself about your insurance carrier’s provisions and requirements for ordering new CRT equipment. The new equipment process takes a little time, but by paying attention to the details and staying engaged with the process, you can help ensure it moves along as smoothly as possible.

Want to know more about the new equipment process?

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