Our Timeline for Wheelchair Ordering

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Mark in new recline wheelchair with adjustable leg rest.

On March 18, 2014, I posted an article titled Wheelchair Ordering Tips. I listed the seven required steps by the medical equipment store and insurance company to get a new wheelchair.

My experience has been that buying a bicycle, car, truck, or any other form of transportation is easier than buying a wheelchair.  With all other forms of transportation you have the opportunity to test them and reject if they do not fit your needs or standards. With a wheelchair you don’t have that option. The wheelchair specialist told us, “There is no option to return because it’s been specifically ordered this way by the doctor and therapist.”

I have three problems with their policy:

1) The wheelchair specialist makes the recommended order after coaching the doctor and therapist and reviewing what is stated in their “Letters of Necessity”.

2) The wheelchair specialist, doctor and therapist don’t use the wheelchair; therefore they can’t know if the wheelchair will meet all the needs of their patient.

3) You don’t even get to see or feel the actual frame, back, cushion, seat pan or leg rest until they all arrive, therefore it is impossible to know how the wheelchair dependent person will fit or feel in the chair until it arrives. The wheelchair specialist can make some adjustments, but when it was still not right we were told, “There has to be some give and take.” Well, in this situation it feels like we are all “give” and the medical equipment store is all “take”. This system of ordering and buying a wheelchair is definitely inefficient.

This is our timeline for the ordering process:

October 16, 2013 – Mark’s doctor’s appointment for wheelchair prescription.

November 7, 2013 – Required appointment with a Seating/Rehab Specialist and Occupational Therapist to establish what Mark would need.

November 25, 2013 – An additional doctor’s appointment was required for a “Face to Face Evaluation” for the “Letter of Medical Necessity” to be sent to the local medical equipment store to send to the insurance company.

November 29, 2013 – Doctor’s “Letter of Necessity” was received by the local medical equipment store.

January 2, 2014 – Required occupational therapist’s “Letter of Medical Necessity” was received by the local medical equipment store. Ball dropped by therapist and wheelchair specialist. This step was completed after my phone calls to both therapist and specialist.

January 24, 2014 – Local medical equipment store sent information to insurance company. I do not understand why the letters were not sent immediately. It took twenty-two days and my prodding to fax the two letters to the insurance company.

January 28, 2014 – Insurance company sends approval notification.

February 5, 2014 – According to my phone call, local medical equipment store sent order for wheelchair to out of state supplier.

February 10, 2014 – According to my phone call, out of state supplier shipped wheelchair from Arizona to Utah.

February 26, 2014 – According to my phone call the local medical equipment store said they only have the cushion seat.

March 17, 2014 – Five months from our first appointment with the doctor the wheelchair finally arrives. We had to reorder cushion, seat pan and leg rests. These original items did not fit Mark’s need.

Mark needs seat pan for stability. Standard fabric bottom does not give enough support.

Mark needs seat pan for stability. Standard fabric bottom does not give enough support.

Recline levers

Recline levers

May 20, 2014 – Seat pan and leg rests arrive two months after they were ordered, a total of seven months from the beginning of this process.

Because it is getting harder for me to transfer Mark in and out of the wheelchair, it was recommended we get one that reclines so Mark could have a change of position.

 

This chair is manually reclined by pushing two levers in the back of the wheelchair, making it impossible for the dependent to do their own reclining. Mark has enjoyed this feature, but because it reclines the wheels are set back on the frame, making it harder for Mark to propel. Now I need to push him around almost everywhere.

 

 

Left leg rest - adjustable Right leg rest - standard

Left leg rest – adjusted down
Right leg rest – standard

Left leg rest - adjusted up Right leg rest - standard

Left leg rest – adjusted up
Right leg rest – standard

The leg rests were also adjustable to correlate with the reclining frame. The problem with those is that when Mark had a seizure or pushed on the foot plates to change his positioning the leg rest would adjust upward and Mark does not have the ability to push the leaver to make them go back down. Try moving around in a house with your legs stretched out twenty-four inches in front of you. The medical equipment store would not allow us to exchange the adjustable for standard leg rests. We had to order new standard leg rests for an additional $210.

Wheelchair 013The frame is longer than the previous chair, making it harder to turn corners and to get into our van that’s customized for a wheelchair. It also sits higher, so we had to make an adjustment to tables and desks Mark sits at.

When you are confined to a wheelchair fourteen to sixteen hours every day it needs to be comfortable and well fitted for all your special needs. Unfortunately, because of the customization they are expensive and because of the many hours per day they are used, they wear out. About every five years you have to go through this drawn-out and frustrating process. The total cost thus far is $8,629.

What I have learned from this experience is that the wheelchair ordering system needs to change. Pictures don’t cut it. Next time we order, I will have my own requirements:

1)    I will have to see and maneuver a like wheelchair frame before we order one.

2)    I will have to see and feel the recommended cushion and back before it’s ordered.

3)    I will have to see and work the leg rests if they are not the standard ones.

4)    I will have to have an estimated cost of each item ordered.

5)    In the future, because my requirements will probably delay the process that has taken seven months in the past, I will need to start this process one year before Mark needs a new wheelchair.

The medical equipment store has a captive clientele and they are being treated unfairly. If we request seeing and trying a similar wheelchair out before ordering it, most likely we will get what our loved one needs at a cost we are prepared for.

Wheelchair Ordering Tips

New Wheelchair-front Buying a bicycle, car, truck, or any other form of transportation is exciting. The ability to get you where you want to go is often taken for granted until it breaks down or becomes hard to use. For most transportation vehicles you’re free to shop around, try out different makes and models, and buy the one that fits your needs.  However, buying a new wheelchair is unfortunately different. If you’ve never bought a custom wheelchair or needed one to get you everywhere you want to go, you’re probably wondering, what’s the big deal! You go into a Medical Equipment Store and try out a few different wheelchairs to see which one fits your needs the best, then order the perfect color and in a day or two have your new wheelchair.

If I could have it my way, it would be done in those three easy steps. But here’s the real deal:

1)      Get a prescription or order from your doctor to start the process.

2)      Meet with a Wheelchair Specialist to discuss the necessary parts for your special needs for comfort and mobility. Unfortunately, there’s no guarantee these parts will work because you’ve never tried them before or even physically seen them. Sometimes it’s a picture from a catalog or the internet.

3)      Meet with an Occupational Therapist (O.T.) or Physical Therapist (P.T.) to assess your needs and discuss the recommendations from the Wheelchair Specialist. The therapist needs to write a “Letter of Medical Necessity” for the Medical Equipment Store to submit to the Insurance Company.

4)      Get another doctor’s appointment to review the recommendation from the Wheelchair Specialist and O.T. or P.T and get a “Letter of Medical Necessity” for the Medical Equipment Store to submit to the Insurance Company.

5)      Make sure the Medical Equipment Store gets both “Letters of Medical Necessity” and submits it to the Insurance Company for authorization.

6)      Wait for the Insurance Company to send confirmation of coverage. Once you’ve received the authorization notice, make sure the Medical Equipment Store orders the parts which consist of a frame, seat, back, leg rests and arm rests.

7)      When all the parts arrive from various manufactures, the Medical Equipment Store assembles it. Once the parts are ordered and the wheelchair is assembled, you finally get to try it. If it doesn’t work, you get to start the order process again for a different part.

 

New WheelchairWhen you are confined to a wheelchair fourteen to sixteen hours every day it needs to be comfortable and well fitted for your special needs. Unfortunately, because of the customization they are expensive and because of the many hours per day they are used, they wear out. So about every five years you have to go through this process. The expense is outrageous, several thousand dollars, and you don’t know the total cost, or your deductible portion until the wheelchair is delivered. The drawn-out process and frustration of orchestrating each step is tiring. You need to supervise every step or they don’t get carried out. If too much time passes the Insurance Company can back out and you have to start the process all over again.

Mark Recline wheelchair

Mark enjoying his new reclining wheelchair

Personally, we started this process on October 16, 2013 with the first doctor’s appointment.  Yesterday, March 17, 2014 (our lucky day) Mark finally got his new wheelchair. Because it is getting harder for me to transfer Mark in and out of the wheelchair, it was recommended we get one that reclines for change of position. It’s very nice, but because it reclines the wheels are set back on the frame, making it harder for Mark to propel. Also the frame is longer than the previous chair, making it harder to turn corners and get into our van that’s customized for a wheelchair. It also sits a little higher making in impossible to get under the table and desk. We’re giving it some time to see if we can make some adjustments, but at this point we are unsure if this wheelchair was the best option for Mark. Unfortunately, this isn’t something you can resell and buy another.

My advice: start this process before your wheelchair needs replacing. If you wait until you need a new one, you’ve waited way too long.