It seems that fewer and fewer funding sources appreciate the benefits of supplying clients with the right wheelchair.
Right wheelchairs are often selected by a user through clinical evaluation, good advice from peers, personal experience, prior education at the School of Hard Knocks, guidance from a dealer, a proper trial of the wheelchair, or a bit of all of these. You did your homework and you’re ready to rock, but so is the insurance company.
So what can you do when that wheelchair slips through your fingers and you find you have a hand full of denial from your insurer? Lots of things actually- Curse and shout, cry, self inflate and tell the world “I told you they wouldn’t go for it”, or try and do something about it. Let me suggest the last choice. It’s not an easy one and is onsiderably tougher than cursing but it offers the best shot at getting your hands on that right wheelchair.
The following are some strategies for getting another shot at funding that wheelchair or at setting the table for the first shot.
Get the real story on what your insurance actually covers. Not a pamphlet, partial copy, or company flyer.
Winning The Health Insurance Game
Don’t wander off course and get lost in the maze.
Insurance Maze from National Spinal Cord Injury Association
From Infinitec.org some good advice that often goes unheeded:
The most important thing you can do is keep a journal!
A plain language guide to setting the table from the Illinois Assistive Technology Program.
Getting A "Yes" From Your Insurance Company.
Quality not quantity of submissions is a key element.
Appealing A Denied Claim.
A how-to on preparing and submitting a Letter of Medical Neccessity.
Insurance 101 from Fight Spinal Cord Muscular Atrophy.
Some dated but still very valid information from New Mobility.
Jumping Through Hoops With Precision.
Make sure the information you supply your insurer is up to date.
Lorraine Woodward of North Carolina was caught up in this.
Stick with it. These things can take a long time. Be accurate and fire your responses off with precision and accuracy. Get all of your medical justifications in detail. Keep records of everything. Don’t generalize and don’t assume that the reviewers will read between your lines. They will most likely be more interested in their own bottom line.
Thank you so much for these links. It’s daunting to sort through everything out there and concrete advice is always appreciated! Thanks again!
Angela
Would you consider mentioning my newly-published memoir on your blog? I would be happy to exchange blog feeds as well.
Seven Wheelchairs: A Life beyond Polio was recently released by The University of Iowa Press.
The memoir is a history — an American tale — of my fifty year wheelchair journey after being struck by both bulbar and lumbar poliomyelitis after a vaccine accident in 1959. The Press says Seven Wheelchairs gives “readers the unromantic truth about life in a wheelchair, he escapes stereotypes about people with disabilities and moves toward a place where every individual is irreplaceable.”
Other reviewers have called Seven Wheelchairs “sardonic and blunt,” “a compelling account,” and “powerful and poetic.”
I hope you can mention Seven Wheelchairs on your blog. We all live different disability stories, I know, but perhaps if you find the memoir worthwhile, you might want to recommend the book to others who are curious about what polio or disability in general.
Of course, the book is also available through Amazon and Barnes & Noble.
–
Gary Presley http://www.garypresley.com
SEVEN WHEELCHAIRS: A Life beyond Polio
Fall 2008 University of Iowa Press