Many health insurance carriers require prior authorization to repair CRT equipment that’s already been approved. The process involves submitting several documents and other information to your insurance provider for approval. Waiting for approvals often adds one to four weeks to the process and can delay CRT users from getting the repair they need.

Key Takeaways:

• Many health insurance carriers require prior authorization to repair CRT equipment that’s already been approved
• The process involves submitting several documents and a variety of information to your insurance provider
• Waiting for approvals from your health insurance carrier often adds one to four weeks to the repair process
• Prior authorization creates bottlenecks in the process, delaying CRT users from getting the repair they need

What Is Prior Authorization?

Prior authorization is an insurance requirement that asks CRT providers to get approval before ordering repair parts, even when the equipment was previously approved as medically necessary.

Required Documents for Prior Authorization

Prior authorization for CRT repairs typically includes several documents, including:

• A prescription
• A repair evaluation
• An equipment or repair estimate
• A Letter of Medical Necessity (LNM)

Why Prior Authorization Delays CRT Repairs

Prior authorization creates bottlenecks in the repair process, mostly because multiple documents must be completed, submitted, reviewed and approved before any parts can be ordered. This delays CRT users from getting the repair they need to enjoy the levels of independence and mobility they desire.

A few ways prior authorization can slow down the process of making timely repairs include:

• The authorization process is lengthy, often requiring several types of documentation to be completed by different members of the CRT user’s care team, including physicians, therapists and Assistive Technology Professionals (ATPs). Waiting for approvals from your health insurance carrier often makes up for nearly half of the repair timeline, adding one to four weeks to the process.
• Authorization is required before ordering equipment or parts needed for a repair. It takes time to order, repair and deliver CRT equipment, and CRT providers cannot start the process until the health insurance carrier has approved.
• If prior authorization is denied, you must appeal the decision, which often means submitting or resubmitting additional documentation and waiting for the health insurance carrier’s decision.
• Even if your chair was previously approved and determined medically necessary, your health plan may require you to submit a prescription or Letter of Medical Necessity (LMN) for most repairs, even replacing a battery. Learn more.

Timeline & Solutions

Reducing or eliminating prior authorization for minor CRT repairs would significantly shorten repair timelines and help users avoid unnecessary health risks. Potential reforms include:

• Removing requirements for a prescription and a statement of medical necessity for repairs to equipment that has already been approved as medically necessary.
• Removing prior authorization or establishing a threshold up to $1,500 for minor repairs or frequently replaced parts to reduce unnecessary wait times and keep CRT users moving.

FAQs

What is prior authorization?

Prior authorization is basically asking your health insurance carrier for permission before ordering the parts to complete a repair on CRT equipment that has previously been approved as medically necessary.

How long does it take?

Prior authorization for CRT repairs often adds one to four weeks to the repair timeline, accounting for nearly half of the total repair process.

What documents are needed?

A prescription, a repair evaluation, an equipment or repair estimate and a Letter of Medical Necessity (LMN).

What if a request is denied?

If prior authorization is denied, the repair is delayed further while you and your care team submit additional documentation, and the insurance carrier reviews an appeal.

Did You Know You Can Make a Difference?

As a CRT user, your experience can help legislators and insurance carriers see the need for change. Legislation that seeks to remove or limit prior authorization is currently being considered in several states.

You can help by:

Educating Yourself

Prior authorization requirements can differ depending on the health insurance carrier. Learn about your insurance carrier’s requirements and who is responsible for each step in the process so you know who to reach out to if documentation is missing or delayed.

NOTE: If you change health insurance carriers at any time during the repair process, you will have to start the process over with your new insurance carrier.

Researching What’s Happening in Your State:

Follow advocacy organizations like NCART, iNRRTS, AAHomecare and other advocates to stay up to date about ongoing efforts and learn what is happening in your state. If legislation is under consideration in your state, research and seek to understand how it would change the prior authorization process for you and your health insurance carrier.

Sharing Your Story:

Reach out to your insurance carrier and elected officials at both the state and federal level and explain how changes to prior authorization would improve your daily life. Find your elected officials.

Making Your Voice Heard:

In many ways, private health insurance plans follow the example of Medicare and Medicaid. Call the Centers for Medicare and Medicaid Services (CMS) directly at 1-800-633-4227 to advocate for changes to prior authorization requirements.

The post Prior Authorization for CRT Equipment Repairs: 7 Facts Every CRT User Should Know appeared first on NSM — National Seating & Mobility.

For caregivers and those who rely on home medical supplies, juggling your supply needs and shipments can easily become a full-time job. National Seating & Mobility (NSM) is already a trusted partner for Complex Rehabilitation Technology (CRT) users, but we can also take the stress and hassle out of managing your medical supply needs — so you can focus on what’s most important to you: living your life. 

In addition to mobility solutions and home accessibility products, NSM also offers a wide range of home medical supplies — including incontinence, urological and enteral. We’re committed to creating a customized experience that works for you and takes away some of the hassle of managing medical supply needs for you or your loved ones.

Medical Supplies and NSM

At NSM, we want to help our clients live life on their own terms. We’re dedicated to helping our clients maintain their independence and self-reliance, and our comprehensive selection of home medical supplies is one of the many ways we do that. 

Whether you’re looking for enteral, urological or incontinence supplies, our dedicated customer care team is specifically trained to guide you through the process and design a tailored medical supplies plan that fits your needs and streamlines your life by making sure you never run out. 

At NSM, we work with all major manufacturers to meet your medical supplies needs, including: 

• Enteral: Medical supplies such as feeding tubes or bags, pumps or formula that deliver nutrition to clients who can’t swallow safely.
• Urological: Medical supplies that help clients with urological needs such as catheters, tubing and more. 
• Incontinence: Products designed to support individuals with incontinence needs. 

Learn more about Medical Supplies and NSM

How It Works

We’re committed to making sure you have the supplies you need when you need them — and we understand the importance of never running out. Here’s how it works:

1. Connect with the NSM Medical Supplies team. Call (844) 292-8887 or email the Medical Supplies Care Team at SuppliesReferral@nsm-seating.com. They’ll walk you through the process step by step.
   
2. Trust us with the paperwork. Our experienced team understands the process of working with insurance carriers to gather the necessary insurance documentation to set up a recurring order. NSM works with most major insurance plans, and our knowledgeable Medical Supplies Care Team members will handle the documentation process from start to finish. Clients work with the same team member throughout the journey, making the process even easier. 

3. Your products are delivered to your door. After your order is set up in the system, it will arrive at your door on a regular schedule, so you always have the supplies you depend on. Your next shipment will arrive a few days before your last order runs out, so you never have to go without vital medical supplies.
   
4. We’ll create an ongoing, customized plan that ensures you have the products you need when you need them. As your paperwork expires, our Medical Supplies Care Team will work with you and your healthcare providers to update your documentation to ensure the shipments you depend on keep coming.

Learn How NSM Can Ease the Stress of Getting Your Needed Medical Supplies

Access to your medical supplies can sometimes mean the difference between life and death — and we understand that at NSM. We strive to take the stress and worry of juggling your medical supplies needs off your shoulders. Whether you need enteral, incontinence or urology supplies, we’re here to make your life a little easier. Learn More

The post National Seating & Mobility Takes the Hassle Out of Managing Medical Supplies appeared first on NSM — National Seating & Mobility.

Ready for a new wheelchair or need a repair to your mobility equipment? Navigating prior authorization requirements with your health insurance carrier can be one of the most confusing parts of the process.

At National Seating & Mobility (NSM), we understand the challenges and we want to help make the process a little less frustrating. In this article, we’ll help you understand prior authorization, the documentation requirements that are part of the new equipment or repair process and share helpful tips to make the process as smooth as possible. 

What Is Prior Authorization?

Prior authorization is basically asking your health insurance carrier or plan to agree to pay for new equipment or a repair to your existing equipment BEFORE anything is ordered. Be aware that some insurance carriers may not require prior authorization in some cases, so it’s important to learn what your health insurance carrier requires. 

The prior authorization process involves several steps and types of documentation, including: 

• A prescription for CRT equipment,
• A seating evaluation to determine the best CRT equipment for your needs,
• An equipment estimate that details the cost of the equipment you need, and 
• A Letter of Medical Necessity is a document that explains why specific medical equipment is essential for your health and well-being. 

Once you submit the required documentation to your health insurance carrier, they will review it and either approve or deny the request based on their specific guidelines for coverage. 

Detailing the Prior Authorization Process for New CRT Equipment

Requirement 1: Prescription for CRT Equipment

What It Is: A prescription from your physician stating that you need to be evaluated for a mobility device. You must have a prescription in order to set up a seating evaluation or request a repair. Most health plans require an in-person appointment with your physician that is focused on your mobility needs.

Who’s Responsible: Your doctor

Requirement 2: Seating Evaluation

What It Is: An assessment performed by a physical or occupational therapist or physiatrist and an Assistive Technology Professional (ATP) to evaluate your physical and functional needs to help determine the best mobility solutions for your needs and lifestyle. 

Who’s Responsible: Your therapists (physical or occupational) or physiatrist and ATP

Requirement 3: Equipment Quote

What It Is: After your seating evaluation, your CRT equipment supplier will create a detailed list of the recommended equipment and their associated costs.

Who’s Responsible: Your CRT supplier

Requirement 4: Letter of Medical Necessity (LMN)

What It Is: A formal letter or document that justifies your need for the prescribed mobility equipment, explaining how it addresses your specific condition, diagnosis and functional limitations. This is completed after your seating evaluation.

Who’s Responsible: Your physical or occupational therapist or physiatrist

Once the required information has been collected, it will be submitted to your insurance carrier for funding review and approval. Documents usually cannot be submitted independently, so know what your insurance provider requires and keep track of any missing documentation so you can follow up with the appropriate person. 

What About Repairs?

When it comes to repairs, many insurance carriers or health plans also require prior authorization before ordering parts to fix the problem. Other documentation requirements that health insurance carriers commonly require for repairs include: 

• An updated prescription or Statement of Continued Medical Necessity, 
• A repair assessment conducted by your wheelchair supplier, 
• A repair estimate, and 
• Proof of Original Purchase. 

How You Can Help

Prior authorization is a team effort! In most cases, your CRT supplier will collect and submit the required documentation to your insurance carrier, but your CRT supplier needs your help to ensure the process runs smoothly. Seek to understand your health insurance carrier’s prior authorization requirements and find ways to support the process. Here are a few ideas of how you can help. 

• Keep copies of all documentation for your own records. 
• Understand your insurance carrier’s prior authorization requirements for new equipment and repairs so you can anticipate documentation needs. 
• Know who to reach out to if a requirement is missing. Stay in contact with your funding specialist so you can quickly follow up on any missing items. 
• Be proactive. Request that your doctor, health care provider or therapists send information to your wheelchair provider as quickly as possible. As the insured person, follow up with your health insurance carrier once prior authorization has been submitted and ask that the decision be expedited. 
• Be prepared. Communicate with your wheelchair provider quickly if there are any updates or changes to your coverage. If you change insurance carriers during the process, understand that all of your information will have to be gathered and resubmitted to your new health insurance carrier, slowing down the process of getting new equipment or a repair. 

Have more questions about NSM’s service and repair process?

Find the answers in our helpful FAQ.

Take Action

Legislation aimed at removing or limiting prior authorization requirements for certain repairs is currently under consideration in several states. If passed, these reforms could significantly shorten the timeline for completing necessary repairs—often cutting delays from one to four weeks, depending on the insurance provider and their policies—ensuring CRT users maintain their independence and quality of life.

• Follow advocacy organizations like NCART, iNRRTS, AAHomecare and other advocates to stay up-to-date about ongoing efforts and learn what is happening in your state.
• Contact your state, local and federal lawmakers to share your story. This resource can help. 

The post Taking the Confusion Out of Prior Authorization appeared first on NSM — National Seating & Mobility.

For a child with mobility issues, Complex Rehabilitation Technology (CRT) equipment can open doors to greater mobility and independence for the entire family. But the process of finding the right mobility solution for your child can be a little overwhelming.

But don’t worry! The world of CRT is filled with tools to help your child thrive in and around your home, including car seats, strollers, wheelchairs, gait trainers, standers, and more. This guide will help you navigate your child’s CRT journey with confidence.

Start Early

If you suspect a delay in your child’s mobility of physical development, don’t wait! Talk to your pediatrician about your concerns and ask about a referral for physical or occupational therapy. Taking these steps early on will give you a better understanding of your child’s needs. 

Believe it or not, children as young as one year old can benefit from standers, and some children may begin exploring power mobility shortly after their first birthday. If your child isn’t meeting traditional milestones, like crawling or walking, it’s important to talk with your physician about your concerns as early as possible.

Find the Right Team

If you’re new to the world of CRT, you may not be familiar with the idea of a seating clinic. Seating and mobility clinics are specialized medical services where trained professionals will evaluate your child to determine the most appropriate mobility equipment to fit his or her needs and goals. 

At an established seating and mobility clinic, you’ll have access to occupational and physical therapists who specialize in body positioning, function and mobility as well as Assistive Technology Professionals (ATPs) from a CRT supplier who are trained experts on recommending and fitting CRT equipment. You may also have a chance to try out different types of equipment so you can better determine what works best for your child—and fits into your life, home and vehicle. 

Finding the right medical provider and physical therapist is the best place to start when building your child’s mobility care team. These professionals often already have an established relationship with a CRT supplier and can streamline the process by connecting you with a supplier in your area. However, if you live in a small or rural community, consider reaching out directly to a local CRT supplier for guidance. They can often help connect you with appropriate medical professionals in your area.

Partner with Your CRT Supplier

The world of CRT can be confusing and overwhelming, especially when you’re trying to make the best decisions for your child. Your CRT supplier is on your team and wants to provide solutions that make life easier for CRT users and their families. You have a shared goal: to help your child live his or her most independent life—and your CRT supplier has experience in providing CRT users with tailored mobility solutions that fit their lifestyles. If a particular mobility solution doesn’t live up to its potential or needs modifications, your CRT supplier is available to work with you and your child to find a solution that works.

Be Patient.

The process to get quality CRT equipment can take time. Here’s a general overview of what to expect. 

1. Referral: Your child’s doctor or therapist confirms your child would benefit from mobility equipment and recommends an evaluation. 
2. Scheduling the evaluation(s). Work with your therapist, CRT supplier or seating clinic to schedule a seating evaluation. 
3. Research recommended equipment: Do your homework after the evaluation to ensure the recommended mobility solution works for your child and fits your life (home, school, vehicle, travel, etc.) 
4. Documentation: While your CRT supplier will gather the needed documentation, you can help by knowing your health insurance carrier’s requirements and working with your provider to ensure documents are collected from different members of your child’s care team—doctor, therapist, you—in a timely manner. Learn more. 
5. Insurance Submission: Your CRT supplier will submit all required documentation to your health plan to obtain prior authorization. It will take time for a decision, sometimes up to 30 days. Additional time may be added if prior authorization is denied or deferred for more information. If there is a partial approval, your CRT supplier will help you determine your out-of-pocket responsibility. 
6. Ordering and Assembly: Once approved, your CRT supplier will order and assemble the CRT equipment for your child. 
7. Delivery and Fitting: Your CRT supplier will deliver the CRT equipment and make sure it fits your child. 
8. Follow Up: Set up a plan with your therapist for growth adjustments every six months to a year. Most pediatric CRT equipment is designed to last 3-5 years, and new equipment may be needed as your child’s needs and goals change as he or she matures. 

Find Your Community

As a parent navigating CRT for your child, you’re not alone! Stay connected to other parents, caregivers and CRT users by attending events like the Abilities Expo and joining online support groups. 

Navigating CRT decisions for your child can feel overwhelming, but it’s worth it so your child can experience his or her greatest levels of mobility and independence. Every child is different, but with early action, expert support and determination, your family can roll confidently into a future full of possibilities. 

The post Navigating CRT for Your Child appeared first on NSM — National Seating & Mobility.

Twenty-five years ago, NSM client Jerry Donovan made a promise—and he’s spent every day since keeping it.

Back then, Donovan worked for Boston Gas, fixing gas leaks throughout the city. In 1999, while driving his truck, his blood sugar suddenly dropped, causing a serious accident. The crash left Donovan—a Type 1 diabetic—with a T-6 spinal cord injury.

“In the ER, a priest came in, and I was an altar boy, so I knew why he was there,” Donovan recalls. “He was coming to give me my last rites. I made a promise to God: If you keep me alive, I promise I’ll do some good stuff.” 

It’s a promise he’s been living out for the past quarter century, as Donovan says, “for people in my position, for people going through traumatic life changes, for people who recover and for the ones who don’t.”

“People need people,” he said. “We pick each other back up when all the cards are down.” 

From Struggle to Service

Donvan’s road to recovery wasn’t easy. 

He credits Molly Sebo, a career physical therapist and clinical specialist—now executive director of SCI Boston, a chapter of the United Spinal Association—for helping him find a way forward. 

“I was a big, strong guy and a hardworking father, and the accident set me back like you can only imagine,” Donovan said. “Molly really helped me get my act together. I was so weak in the beginning that I couldn’t even push my chair up a little ramp. Things felt like they’d never change, and, if they did, never for the better. It can be very easy to become jaded.”

At first, Donovan struggled to adjust to life as a paraplegic. “I wasted a year not really listening,” he admits. But as he grew stronger, he realized he wanted to help others facing similar challenges. So, he became a peer mentor with SCI Boston, serving at Boston’s Spaulding Rehabilitation Hospital. 

“I would go into someone’s room and show them someone in a wheelchair with a smile on his face,” Donovan says. “I would tell them the truth: that this is going to be a difficult process, but with love and support, you can do this. 

“It’s a full-time job, plus overtime, being paralyzed and you really have to work hard to be the best person you can be with your disability,” he says. “Disability defines your character.” 

Building Community Through Golf

In 2011, Donovan took his mission further by co-founding Golf for All, a Massachusetts-based nonprofit that brings people of all abilities together on the golf course. Since then, Golf for All has organized numerous free golf clinics to help people with disabilities of all kinds enjoy the therapeutic and social benefits of golf. 

“Golf for All challenges people to get out and play nine holes with their families and friends,” Donovan says. “It really turns into a support group, and you end up having all these players out on the course who are just having fun.” 

A hockey player before his spinal cord injury, Donovan discovered adaptive golf while participating in an adaptive sports event at Spaulding Rehabilitation Hospital. Some of the skills he’d honed as a hockey player transferred right over to golf, and Donovan loved the sport from his first swing. 

“I only drive with one arm, and back when I first started playing golf, I was always trying to hit it harder,” he says. “But now I have a nice smooth stroke and it goes straight down the middle.” 

Expanding Access, Creating Joy

Donovan is committed to increasing access to the game of golf. In partnership with the Massachusetts Department of Conservation and Recreation (DCR), he helped acquire Paragolfers—adaptive devices that let wheelchair users stand and swing.

These specialized machines are available for rent at two Boston-area courses: Leo J. Martin Memorial Golf Course and Ponkapoag Golf Course.

“These machines are getting used,” Donovan says. “They’re not just for people who are paralyzed—they help people of all abilities get out on the course and have fun.”

One of Donovan’s favorite Golf for All programs is a driving range clinic for adults on the autism spectrum.

“I’ve found that adults with autism and kids with disabilities really enjoy being around others with similar abilities because no one picks on them,” he says. “We’re not playing nine holes, but they let everyone know they’ve been ‘playing golf.’ It’s about being together, outside, having fun. I love organizing and participating in it.”

Living Out His Promise

Today, Donovan continues to honor the vow he made in that ER more than two decades ago. 

“I’ve been helping people for 20 years now, and some of them have gotten better than me at golf,” he says with a laugh. “But you need that competitive fire. Keep working, keep trying to challenge yourself. Golf may not work for everyone, but find something you like to do and stay active.”  

The post A Promise Kept: Jerry Donovan’s Mission to Help Others Thrive appeared first on NSM — National Seating & Mobility.

Most private health insurance carriers and state Medicare or Medicaid programs do not cover transportation to wheelchair evaluation or repair appointments. Coverage that does exist varies widely by state and provider. If CRT appointments are covered under non-emergency medical transport (NEMT) provisions, health insurance carriers often set specific medical necessity requirements that CRT users must meet. In many cases, a healthcare provider must make the request for transportation and provide documentation that it is medically necessary. 

Educate Yourself: To learn more about what’s included or required in your state’s Medicaid program, please reach out to your state’s Department of Health and Human Services or comparable department. Find your state’s department here. If you’re covered by a private insurance carrier or Medicare, reach out to your insurance carrier for more information on what types of transportation may or may not be covered under your plan and the process for using those benefits to cover transportation to your CRT branch appointments.  

How Would Covering Transportation Help CRT Users? 

When it comes to CRT equipment, there’s no “one size fits all.” Each mobility device is highly customized to meet each individual user’s specific needs. A customized manual or power wheelchair can consist of a variety of individual components—all of which require frequent adjustments and repairs since CRT equipment is used on a daily basis. Because of this level of customization, many repairs need to be made by certified technicians. If CRT users can’t travel to their wheelchair provider for an appointment, the technician will come to them. 

Data tells us that 85% of repairs are completed in the home, and in-home repairs are always an option, especially for CRT users who are unable to travel due to their condition or other factors. But if you choose an in-branch appointment, there are benefits including:  

• In-branch repairs give technicians access to more parts than can be stocked on a van as well as specialized equipment/tools and the space needed to complete complicated repairs. 
• If an additional repair or maintenance need is discovered, the technician may be able to complete them without scheduling a follow-up appointment. 
• Technicians can see more CRT users in a day and serve them more quickly. 

If Medicaid, Medicare and private health insurance carriers covered wheelchair evaluation and repair appointments under their NEMT provisions, more CRT users would have access to their local branches for CRT-related appointments, protecting their health, preserving their independence and helping to keep their wheelchairs in optimal working condition.

Did You Know You Can Make a Difference? 

As a CRT user, your experience can help legislators and health insurance carriers see the need for change. Here’s how you can help: 

Pay It Forward: If you are able to travel to a local branch for a repair appointment, please consider doing so. This often results in a quicker repair timeline for you and allows technicians to prioritize CRT users who cannot travel due to diagnosis, condition or other factors with in-home appointments, ensuring everyone gets the help they need as quickly as possible. 

Share Your Story: Reach out to your state’s health and human services department and elected officials at both the state and federal level and explain how accessible transportation policies affect you. Find your elected officials. 

Make Your Voice Heard: Contact your health insurance carrier or Medicaid advisory groups. Call the Centers for Medicare and Medicaid Services (CMS) directly at 1-800-633-4227. 

The post Did You Know: Transportation Coverage appeared first on NSM — National Seating & Mobility.

When your complex rehabilitation technology (CRT) equipment breaks down, getting it repaired as quickly as possible is critical. Your chair is what keeps you moving through life. 

But CRT repairs take time. Many factors influence the repair timeline—from insurance documentation requirements to the review and approval process—and a lot of them are outside of the CRT user’s control. Even so, there are some proactive steps you can take to help keep the repair process moving as quickly as possible.

How Can You Help Speed Up the Repair Process?

Tip 1: Report the problem BEFORE it becomes catastrophic. 

Joystick not working properly? Notice a problem with your tire, footrest or battery? Report the issue to your CRT provider as soon as possible so that a small problem doesn’t become a full breakdown. Your wheelchair provider will set up an evaluation to determine what’s causing the problem. In some cases, a technician may be able to perform a remote evaluation, but if that is unsuccessful, you may need to schedule an in-branch or in-home evaluation appointment. 

Tip 2: Understand insurance requirements and approval times. 

Data tells us that almost 45% of the repair process is spent collecting documentation and waiting for insurance approvals, making this one of the most time-intensive parts of the process. Before parts can be ordered or repairs begin, most insurance carriers require prior authorization, which usually includes a repair evaluation and estimate as well as documentation of medical necessity and other requirements. 

You can help the process along by: 

• Understanding what documentation your insurance carrier requires. Learn more about common documentation requirements and seek to understand who is responsible for each, so you know who to contact if something is missing and can help urge them to quickly provide the required documents.  
• Reach out to your insurance carrier during the process to ensure the required documents have been received. 
• As the policyholder, request an expedited review of your documents, stressing that it is important that a decision be made quickly. 
• Keep copies of all the documentation you, your physician, or wheelchair provider have submitted to your insurance carrier and record when those documents were submitted.

Tip 3: Describe the problem as clearly as possible. 

When you reach out to your CRT provider for a repair evaluation appointment, strive to explain the issue as clearly as you can. State what part or parts are affected, what is or isn’t working, when the issue started, and if it’s gotten worse over time. 

Other advice: 

• Want your technician to see what you’re dealing with? Take a quick video when the issue occurs so that you can show them the problem and how it’s affecting your daily life. 
• Take photos of any damage or wear and tear that may help the technician diagnose what’s wrong with your CRT equipment.

Tip 4: Keep a maintenance log. 

Your CRT equipment needs to be in top working order to ensure you can achieve the highest level of mobility and independence you desire. Keep track of repairs and previous problems so you’re well informed about what’s been tried before and what hasn’t. Your records can help add additional information and details to those your technician and wheelchair provider have on file, helping them make an informed diagnosis as quickly as possible. 

Tip 5: Stay informed about your order. 

Seek to keep track of your order as it moves throughout the process. Many CRT providers, NSM included, offer online order tracking that helps you stay informed. If you are an NSM client, you’ll simply need to submit your first and last name and order ID at mynsmorder.com to track your order. If you don’t have your order ID, please email NSM’s customer care team at info@nsm-seating.com to retrieve that information. 

Keep in mind that CRT equipment is comprised of thousands of parts. While CRT suppliers keep a large supply of parts, they can’t feasibly stock every part that might need to be repaired. If a part needs to be ordered, it can add a little time to the process. By staying in touch and asking for updates, you help ensure the lines of communication stay open throughout the process. 

Take Action

Most insurance carriers require prior authorization for many (and sometimes, all) repairs. Often, this includes submitting a prescription and/or statement of medical necessity to prove you need the mobility equipment, even when the equipment was previously approved. 

Educate Yourself: Seek to understand your health plan’s prior authorization requirements and note how the prior authorization process slows down a needed repair. NSM completes more than 100,000 repairs each year and receives payer approval for more than 93% of them, meaning that prior authorization may not be necessary on most repairs. If prior authorization were removed for repairs under $1,500, it could help speed up the process by one to four weeks.

Connect with Advocacy Partners: Legislation is already under consideration in some states to remove prior authorization for some repairs, or if the mobility equipment has previously been approved by an insurance carrier as medically necessary. Connect with advocacy organizations like NCART, iNRRTS, AAHomecare, and other advocates to stay up-to-date about ongoing efforts and learn what is happening in your state.

Share Your Story: If legislation concerning the elimination of prior authorization is being considered in your state, reach out to your elected officials and share how this change would improve your daily life. 

The post Five Tips to Help Speed Up the Repair Process appeared first on NSM — National Seating & Mobility.

Gearing up for your first evaluation for mobility equipment or want to make the most of your next appointment with your Assistive Technology Professional (ATP)? Consider these tips to help you prepare

Be Ready to Communicate Your Mobility Goals 

As the Complex Rehabilitation Technology (CRT) user, you need to be able to tell the story of what you want to accomplish — and that includes your personal and professional goals as well as how you like to spend your free time. If there’s something you want to be able to do or a particular mobility need you have, be prepared to talk to your ATP about that desire and why it’s important to you. The more clearly you or your caregiver can communicate that need or goal, the better. 

Be Able to Explain What’s Not Working

If something isn’t working quite right with your mobility equipment—from a faulty joystick or failing battery to a hard-to-maneuver manual chair—be prepared to communicate the problem in detail to your ATP. If you cannot communicate it yourself or don’t feel comfortable sharing about your personal circumstances, ask a caregiver or friend to accompany you and help you communicate your needs and desires. 

Review Your Insurance Coverage and Advocate for Yourself

As the insurance policy holder, you need to know and understand what your insurance provider covers and what it doesn’t as well as any documentation requirements they may have. By understanding what documentation is required to prove medical necessity or move the order forward, you can proactively advocate for yourself with your physician and therapy teams to help us obtain the necessary documents and forms. Once documentation has been submitted to your insurance provider, you can contact your provider to expedite your authorization. And—whether it’s your first evaluation or your 100th—be sure to bring your insurance card and other important information to the appointment. 

Do Your Research

Prior to your appointment or evaluation, take a look at the manufacturer’s website to learn more about what’s currently available and might fit your needs. While you may ultimately end up with a different mobility solution, having a solution in mind can help the ATP better understand what you want or need. Come to the appointment prepared to try out a new seating system or piece of equipment or to be assessed while operating the equipment or driving the chair. 

Ask Questions

Make a list of questions you want answered or information you need to understand during the appointment and go over it with your ATP. Ask to be educated on how your equipment works and what you can do to help maintain it and for documentation that supports these efforts. 

Seek to Understand the Process

Whether you’re ordering new equipment or getting a repair, understanding the nuances of the process can be helpful. Ask your ATP to explain the timeline or provide documentation that helps you better understand next steps. While you don’t need to be an expert on every detail, being familiar with the process can be helpful. 

Have more questions about NSM and mobility solutions? Check out these FAQs. 

The post How to Prepare for Your Mobility Equipment Assessment appeared first on NSM — National Seating & Mobility.

HOW THE SUPPLY CHAIN CRISIS HAS AFFECTED CRT USER

Last fall, gridlock in America’s largest ports dominated news headlines. As cargo ships circled off the ports of
Los Angeles and Long Beach waiting to offload their cargo, many of us pondered the state of the country’s supply
chain for the first time.

Over the past year, the supply chain crisis has created delays and frustrations, from long waits for new furniture
to the rising price of a new car. But the slowdown is more than a hassle to complex rehabilitation technology (CRT)
users. The strain on the supply chain has slowed deliveries and delayed repairs and other vital services necessary
to keep CRT users moving.

So, what’s the problem? And, more importantly, what’s being done to fix it?

What to Do

If you think your recent order may have been affected by the supply chain crisis, what should you do? Track your order. Some providers offer an online status update tool where you can go to get the latest information on the status of your order. For example, the order status update tool NSM offers is mynsmorder.com. Reach out to your local provider. Give them a call to better understand where your order is in the process and to identify issues that may be causing a delay. Advocate for Yourself and Others. As supply chain challenges continue to drive inflation in CRT costs due to freight, labor and raw material/part costs, insurance considerations regarding reimbursement adjustments will become even more important. Contact your senators and representatives by visiting congress.gov

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THIS OVERVIEW AIMS TO MAKE THE PROCESS MORE TRANSPARENT—AND HOPEFULLY A LITTLE EASIER TO NAVIGATE THE NEXT TIME YOU NEED NEW EQUIPMENT.

Phase One: Evaluation & Design

Receive Your Assessment
Your healthcare provider must write a prescription for a seating evaluation. Your Assistive Technology Professional
(ATP) will work with you and your healthcare team to determine your needs and design a mobility solution.

How to Help

• Share any issues with your current equipment.
• Give honest feedback.
• Provide accurate information about your insurance or funding source.

Phase Two: Funding & Approval

Collect and Submit Your Paperwork
Your funding specialist will gather required documentation needed for prior approval. When all of the necessary information has been gathered, your funding specialist will submit your paperwork to your insurance or funding source.

Await Insurance Approval
After submitting all the required documentation, your funding specialist will follow up with your insurance provider or funding source regularly. This process could take a while—and insurance providers may deny some of your equipment or customizations.

How to Help

• Contact your medical provider and ask for your documentation to be expedited.
• Call your insurance company and ask to expedite the review.
• Appeal directly to your insurance company if you’re denied. Your team can help you resubmit.

Phase Three: Purchase, Assembly & Delivery

Place Your Order
After receiving approval from your insurance provider or funding source, the order is placed for your new equipment. Technicians will then assemble all components, creating your custom mobility solution. Due to supply chain issues, it may take longer than normal to receive products.

Schedule Your Delivery and Get Moving
When your equipment arrives and is ready for you, a customer service specialist (CSS), ATP and technician will work with you to schedule delivery. Your equipment may be delivered with the support of a therapist and/or in a clinic setting. Your ATP and technician will work to make any necessary adjustments and make sure you know how to use your new equipment.

How to Help

• Communicate changes quickly (if you move or change providers). A failure to do so could result in paying out-of-pocket.
• Ensure your equipment meets your satisfaction before the order is finalized. Medical equipment can’t be returned, so don’t be afraid to speak up!

Get to Know Your Team

At National Seating & Mobility (NSM), a team of specialists will guide you through the new equipment process. These knowledgeable specialists understand the intricacies of the process. While all suppliers follow a similar process, they may not offer the same level of guidance or dedicated team approach as NSM.

Assistive Technology Professional (ATP)
Certified professional who works with you and your care team to analyze your mobility needs and recommend solutions.

Customer Service Specialist (CSS)
Customer service specialists support customers, answering questions and helping you stay up to date on your order.

Healthcare Provider
Your physician, who understands your overall health needs.

Therapist
Physical or occupational therapists experienced in mobility equipment evaluations who understand your health situation and needs.

Technician
When your equipment is ready, your ATP and technician will work to make any necessary adjustments and answer your questions.

Funding Specialist
An expert who will coordinate the entire funding process from beginning to end, working to gather, complete and submit all necessary documentation to your insurance provider or funding source— and support you in the event of a denial.

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