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: Facts Every CRT User Should Know appeared first on NSM — National Seating & Mobility.

Adaptive technologies contribute to improved outcomes by:

• Increasing independence and social engagement, including self-care
• Supporting physical, emotional and cognitive development
• Enhancing quality of life and boosting caregiver confidence
• Enabling safe participation and connection within the home and community.

Real-Life Example of How a Safety Bed Changed Liam’s Life

Like most parents, Brian and Agustina McCarthy want to ensure their son, Liam, is happy, healthy and safe. But because Liam, who’s 7 years old, lives with Level 3 autism, PICA and epilepsy, that can be a little more complicated for the McCarthy family. 

“There’s a level of focus that’s required when monitoring Liam that we never knew we had or could even be achieved,” Brian says. “He’s a wonderful, caring, loving, curious, determined and silly little man, but his body is compelled to consume non-food items and seek sensory input by climbing on anything and everything tall.” 

Liam, who was diagnosed with Autism Spectrum Disorder when he was around 4 and epilepsy just last year, lives an active life. Brian describes his son as having “impeccable balance,” but because of Liam’s epilepsy diagnosis, climbing can be dangerous. 

His parents make sure he’s supervised during the day, but nighttime proved to be a little harder to manage. After a night when Liam climbed atop his bureau to fall into his bed, his parents knew they needed a safety bed in addition to video monitors. 

“After his epilepsy diagnosis, they told us he really shouldn’t be climbing anything higher than two feet,” Brian says. “It’s a huge danger if he wakes up in the middle of the night, doesn’t make a peep and climbs [on top of his bureau], and we don’t wake up. It’s a very serious safety issue.” 

Even before Liam was diagnosed with epilepsy, helping him to settle and safely sleep through the night had been difficult.

We’ve spent at least four years anxious about Liam quietly engaging in dangerous sensory seeking or self-injurious behavior while we’re sleeping,” Brian says. “We’ve put 28,000 miles on our car in nine months just to drive him around to get him to sleep.”

Brian, Agustina and Liam’s ATP, Peter Eastman, initiated the process of ordering a safety bed at their local NSM branch, then worked with Kim Giordano, NSM Funding Supervisor, and Justyna Wozny, an NSM Funding Specialist, to navigate the insurance approval process. Liam received his Cubby Bed in March of last year. 

“Kim and Justyna were so understanding of our need for things to be expedited,” Brian says. “At each step, they told us exactly what actions we needed to take to move the process further to completion. They were incredibly knowledgeable, friendly and nurturing during what can be an absolutely crazy, intimidating, confusing and frustrating process.” 

For the McCarthy family, the experience was a primary example of NSM working to meet client needs — something NSM’s funding team prides itself on, according to Kim Giordano, NSM Funding Supervisor. 

“We strive to be subject matter experts and advocate fiercely for our clients to ensure they receive the necessary equipment,” Giordano says. “It was rewarding for Justyna and our team to be a part of an effort that allows this family to rest peacefully at night, knowing their son is secure.” 

Learn More about how NSM Can Support You

Due to autism, PICA, and epilepsy, Liam required a safe nighttime solution to prevent injury. A medically approved safety bed provided security, improved sleep, and peace of mind for his family. 

NSM is here to help. With expert guidance and access to trusted equipment — from sleep‑safe beds to adaptive seating and communication tools — our team partners with families to build environments that truly meet each child’s unique sensory and safety needs. Connect with NSM today, and let’s create a space where your child can thrive.

Find a location near you to start the conversation about your customized mobility and accessibility needs.

The post How a Safety Bed and Home Mobility Solutions Helped Liam and His Family appeared first on NSM — National Seating & Mobility.

Custom mobility solutions change lives by: 

• Increasing independence and social interaction,
• Supporting physical, emotional and cognitive development,
• Improving caregiver confidence and quality of life, and 
• Enabling safe participation and connection within the home and community.

Real-Life Examples of Restoring Independence Through Custom Seating

National Seating & Mobility (NSM) ATP Chris McNulty has been working in the home medical equipment industry since the 1990s and currently serves clients in the Troy, Michigan, area. He recently worked with a pediatric client, Kendric, who was recovering from an extended illness that had left him bedridden. 

The extended time in bed affected Kendric’s posture, so much so that his existing seating system no longer fit him. McNulty, working in cooperation with Kendric’s doctors and therapists, set out to find a solution. 

“Because of the length of time that he spent in bed, he had contractures and had developed some atrophy,” McNulty recalls. “The challenge became, ‘How can we accommodate his new posture and still use his existing chair?’”

It took a little creativity to figure out how to mount Kendric’s new seating system to his existing chair, but McNulty and the care team eventually found a solution. McNulty went to the family’s home to make the delivery and do the final fitting. 

“When I went out to their home, his parents got him out of bed, sat him up in the chair, and the first thing they did was turn on the TV,” McNulty says. “Kendric was able to sit up and watch his favorite show for the first time in months.” 

Kendric’s parents were ecstatic to see their son enjoying something he loved — and ecstatic to see him smile for the first time in months. 

“It was the first time they had noticed him smiling in a long time, and it was a joyful moment,” McNulty says. “We all shared a big smile.” 

Now fully recovered, Kendric and his family are also able to enjoy their community together, thanks to his new seating system. 

“When he started to feel better, Kendric really couldn’t get out because his old seating system didn’t fit him correctly anymore,” McNulty says. “This is a quiet reminder that what we do as clinicians, as ATPs, as physical therapists and occupational therapists — we really are a voice for our patients who may not have a voice because of medical fragility or maybe don’t know how to advocate for themselves. 

“So we have a responsibility to do what we can,” he continues, “so they can get the equipment they need and deserve to live fulfilling lives.”

Learn More about NSM’s CRT Process

After an extended illness caused significant postural changes, Kendric needed a custom seating solution to regain comfort and function. A collaborative CRT approach restored his ability to sit upright, engage with his environment, and return to community life. Learn more about the NSM process.

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Custom mobility solutions change lives by: 

• Increasing independence and social interaction,
• Supporting physical, emotional and cognitive development,
• Improving caregiver confidence and quality of life, and 
• Enabling safe participation and connection within the home and community.

Real-Life Examples of CRT Equipment in Action

At 4 years old, Cyrus — known to his family and friends as Zippy — was born with arthrogyposis multiplex congenita (AMC), a condition characterized by stiff joints, contractures and tight muscles that severely limit mobility. Zippy started therapy eight hours after birth, his mom, Cindy Mood, recalls, and he was just shy of his first birthday when the Moods began considering a wheelchair to increase Zippy’s mobility. 

“We had a stroller, but it wasn’t allowing Zippy as much visibility,” Mood said. “He was a little less than 1 year old when we got his first manual wheelchair through National Seating & Mobility (NSM). That was a real game-changer, and he was so proud to be sitting up in his chair, and it gave him more freedom.” 

As Zippy grew, his parents and care team wanted to provide as many opportunities as possible for him to enjoy independent mobility, just like his peers. When he was about 2 years old, they began considering a power chair. At first, the Moods and the care team looked into head controls because of Zippy’s limited limb mobility, but the solution ultimately turned out to be a joystick paired with arm supports. 

These tools allow Zippy to zip around with the exuberance of his 4-year-old peers and enjoy the physical, emotional and cognitive benefits of independent mobility.

“Probably the biggest thing is that Zippy and his sister are able to play together,” Cindy says. “Having this equipment and the NSM team, including our Assistive Technology Professional (ATP) Ryan Martin, gives Zippy greater confidence, and he benefits physically, mentally, emotionally and socially from being able to interact on his own. As caregivers, it takes a little of the weight off our shoulders.” 

Learn More about NSM’s Mobility Solutions

Zippy’s custom pediatric wheelchair and assistive technology gave him independent mobility, improved muscle development, and the confidence to interact with peers—demonstrating how early access to CRT equipment can transform childhood development.  Learn more about what NSM has to offer.

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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 wheelchair breaks down, you just want to get it fixed as quickly as possible. A repair evaluation with your wheelchair provider at the local branch is often the fastest way to get the repair started, but getting there can be an issue. 

Concerned about transportation to get you and your wheelchair to your provider’s branch for new equipment evaluations or repairs?  Here are a few transit options and resources to consider when needing a ride:

Paratransit

Paratransit services are designed specifically for people who cannot use regular public transit systems, such as individuals with disabilities or senior adults. Generally, paratransit offers door-to-door service, flexible routes and scheduling with accessible vehicles designed to accommodate mobility devices. Examples include Access-A-Ride in New York City or MetroAccess in Washington, D.C. Research your local transit system to see what paratransit options may be available in your area. You may need to meet specific criteria to qualify, and reservations may be required.

Transportation Voucher Programs

These programs offer vouchers or credits that can be used to pay for rides that cover public transit, rideshare services, taxis, paratransit or other transportation options. Programs may have eligibility requirements (sometimes based on income, disability, geographic location or other factors), and voucher programs may focus on different needs, such as medical transport, employment-related travel or general mobility. Examples include RideLink in San Diego County, California, or Dial-A-Ride, which is offered in various locations.

Wheelchair-Accessible Rideshares or Taxis

In larger cities, accessible taxis might be an option to get back and forth from your local wheelchair provider for an appointment. Some rideshare services provide wheelchair-accessible vehicle options, but be aware that these services may need to be scheduled in advance.

Local Nonprofits or Charities

In some locations, nonprofits, senior centers or disability organizations provide accessible transportation for medical appointments. Churches and other faith-based organizations may also be an option in your area.

Pay It Forward: If you can travel to your wheelchair provider’s local branch for an appointment, do so. This can not only facilitate the repair process for your chair, but will help technicians who travel to in-home appointments prioritize CRT users who cannot travel, ensuring everyone gets the help they need as quickly as possible.

Remote Evaluations: First Step in the Repair Process

More and more often, the first step in the repair process is setting up a remote evaluation with a technician to determine what might be wrong. Sometimes, the problem can be determined remotely, and, if not, the remote evaluation allows the technician to better prepare for an in-person evaluation. If you’re client of NSM, contact your local branch to learn more.

ADVOCACY ALERT

If more insurance providers covered transportation for CRT-related appointments, it would help keep more CRT users moving through life with the mobility solutions they need for greater independence and healthier lives. Here’s how you can help:

Educate Yourself: To learn more about what’s included or required by 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 provider or Medicare, reach out to your provider for more information on what types of transportation may or may not be covered under your plan.  

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 their accessible transportation policies affect you. Find your elected officials. 

Make Your Voice Heard: Contact your insurance provider or Medicaid advisory groups to reinforce the importance of accessible transportation for CRT services. Call the Centers for Medicare and Medicaid Services (CMS) directly at 1-800-633-4227. 

Engage with advocacy groups and advisory boards. Advocacy organizations such as the National Organization for Assistive and Rehab Technology (NCART), the ITEM Coalition and nonprofits or advocacy groups around specific diagnoses, like the Muscular Dystrophy Association (MDA) or United Spinal Association, can all be helpful in guiding you as you advocate for change.

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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. 

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BUDGET FRIENDLY IDEAS FOR CREATING ACCESSIBLE HOMES

Inaccessibility tends to show itself in the details, and they’re often hardest to spot at home. Since it’s a place that’s filled with the flurry of daily tasks and the comfort of treasured memories, it can be hard to notice when these spaces aren’t exactly welcoming to a range of bodies.

“An accessible home is for people of all ages,” says Cindi Petito, a home accessibility expert based in Jacksonville, Florida. “It doesn’t matter if you’re a child, someone with a disability, or a senior. An accessible home is a liveable one.”

Perhaps steps to a front door lack a railing, or there’s a bathtub with high edges. Maybe door frames are too tight for wheelchairs, or furniture is too low to the ground. Once you begin to pinpoint all the ways a home could be more accommodating, it can seem like a very long list—and an expensive one at that. Thankfully, Petito knows how to approach this task on a budget, using three solutions she describes as low-tech but high-impact. “If people can be proactive about access, it saves them the trouble of potentially being reactive later,” she says. Read on for her insights.

1. PAY ATTENTION TO WHAT’S ON THE FLOOR.

The fastest way to remedy a home’s hazards is to ensure that there’s enough storage to keep clutter off the floor. “The first thing I think about is how to prevent falls,” she says. After that, account for other low-hanging aspects of a possible obstacle course. Is the corner of a rug turned up, or is one needed to cover a slippery surface? Is there a loose board or stone in a walkway? Keep in mind that smooth transitions are best for everyone

2. MAKE SURROUNDINGS EASY TO SEE.

“A lot of homes, especially older homes, don’t have enough lighting,” Petito says. Adding table lamps to living rooms, sconces beside beds, or even LED strips under kitchen cabinets can illuminate surfaces and make edges more apparent. Don’t forget about lighting outdoor pathways and entrances, too, and consider installing timers for well-trafficked areas.

3. PLACE POPULAR ITEMS FRONT AND CENTER.

“If it’s too cumbersome to prepare a meal because ingredients or tools are out of reach, then that’s dangerous physically and nutritionally,” she notes. Store everyday utensils and spices in a grab-and-go location, and put the microwave closer to the ground. In fact, this habit should be a part of every room. “The things we use and wear everyday should always be easily accessible,” Petito says

The post Easy as 1, 2, 3 appeared first on NSM — National Seating & Mobility.

Hire more people with disabilities. Would you start an airline without hiring pilots as consultants?

Read our Wheelchair Guide

Live in Kansas City? Kansas Wheelchair Tips

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CREATING HAPPY & HEALTHY ENVIRONMENTS FOR A LIFETIME

IN 2021, THE YOUNGEST BABY BOOMER WILL BE 57 YEARS OLD, WHILE THE OLDEST WILL TURN 75.

With an estimated 73 million seniors over the age of 65—most of whom prefer to stay in their homes throughout their lifespan—it’s vital for seniors to take steps now to make that goal a reality.

Design Concepts

Creating a safe home means a healthy home that supports active seniors and mitigates potential falls and serious injuries before they happen. When home accessibility specialists complete safety recommendations, they consider design and aesthetics inside and outside the home.

There are several design concepts and terms used to describe accessibility.

Universal Design (UD) is used primarily in the United States. UD is the design of products and environments that are usable by all people, to the greatest extent possible, without the need for adaptation or specialized design.

Most home accessibility specialists in the U.S. also use the Americans with Disabilities Act (ADA) standards. These guidelines are in place to ensure accessibility to public places and commercial facilities. While these standards are used as a guideline for measuring the home environment, evaluating the individual and their functional abilities in the home will maximize independence, health and well-being. It is also important to prevent “minimal compliance practice” when using ADA standards, which can lead to creating environments that look institutional or create barriers for others who reside in the modified home.

Temporary or Permanent Solutions

Home safety and accessibility products range from simple solutions such as handrails and grab bars to more complex structural changes such as a bathroom modification with a curbless walk-in shower. Available in both temporary and
permanent options, these solutions not only offer safety features to help prevent falls and serious injuries, but also include a wide variety of colors, shapes and materials to create a home design that is right for you.

Plan Ahead

Seniors should take steps to have their homes evaluated for potential safety hazards before a fall happens. Planning ahead is key to preventing a life-altering event, which can have both physical and financial impacts. Planning ahead also gives seniors time to design their homes to meet their personal needs and design styles. Rather than installing products during an emergency situation, planning ahead can allow you to make sure both your physical and design desires are met. Being able to functionally and safely engage in your home environment in meaningful ways is vital to supporting health and happiness throughout the golden years.

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