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Will Spectrum Medical work with my insurance to purchase wheelchairs?
Yes, Spectrum Medical will work with you to bill your equipment to your insurance carrier and this is done through our Patient Billing Services Department (PBS). Please navigate to that link for additional information on this service.
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Does Medicare assist with funding a scooter or power wheelchair?
Yes, Medicare does provide a benefit for a recipient to obtain funding for a scooter or power wheelchair. However, this benefit is closely monitored by Medicare and there are several steps in completing this process. With each type of scooter or wheelchair, Medicare does offer a maximum allowable charge and pays a percentage of that allowable charge, generally 80%. This does not mean that you are guaranteed coverage nor does it mean that you will not be responsible for charges over the allowable and co-pays. If you should require detailed information about coverage criterion or allowable for a product, please contact our Patient Billing Services for more information.
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What does “same or similar” mean?
Same or similar is a term used by Medicare to establish a group of products together that tend to do the same thing. According to Medicare, a cane, crutch, or walker are the “same or similar” to a wheelchair since all of these products are providing a means of mobility for a person. However, since these items are considered the “same or similar”, Medicare will look closely at any requests for a wheelchair if you have received a cane, crutch or walker from them in the past. This does not mean that if Medicare purchased these other items you will not be able to get a wheelchair, it simply means that we must explain in detail your new request. Our Rehab Department is well versed with Medicare coverage criterion and would be happy to assist you.
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How do I know if I qualify for a manual wheelchair through Medicare?
Medicare does have detailed coverage criterion for manual wheelchairs and it has been changed recently. To qualify for a manual wheelchair you must have the need for the item within your home, you must have difficulty with or be unable to walk, and you must not be able to use a cane, crutch or walker to perform basic daily functions. If you meet these basic requirements, it is time to speak with your doctor to see if a wheelchair is right for you.
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If I have Medicare and get around OK in my home but need a wheelchair or scooter to get out of the house, will they help me pay for one?
No. Medicare’s coverage criterion is very clear - you must have the need for the equipment within your home to qualify for any type of powered equipment whether it is a scooter or power wheelchair. Your doctor, physical therapist, occupational therapist and Spectrum Medical Rehab staff can assist you in determining whether you will meet this basic requirement.
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What is an Advanced Beneficiary Notice (ABN) and what does it do?
An ABN is a form produced by Medicare and it explains why some goods will not be covered by Medicare and why we think it may not be covered in your particular situation, it further explains what the charge for the un-covered item(s) is/are and that you are aware that you will be billed personally for those goods if you should wish to keep them. Once this information is explained to you, the ABN will reflect your wishes to keep or refuse the goods then, finally you sign to the form to confirm your wishes. This form is used to ensure that you, as a Medicare beneficiary, are well informed and treated fairly at the time you are receiving the goods you had requested.
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If I can’t get out of my home and need to get a wheelchair, how do I get started?
When you and your doctor decide it is time to move forward in pursuing a wheelchair, you only need to call our offices at either 1-800-870-9322 outside of Great Falls or 727-9322 inside Great Falls and we will help you with the rest. So sit back and call, we are sure you will be happy that you have chosen Spectrum Medical as your provider!
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I have Medicare and want to get a power wheelchair, how do I get started?
The new Medicare requirements state that you must meet with your doctor for a dedicated “face to face” evaluation to discuss your need for powered mobility. That evaluation addresses specific coverage guidelines that your doctor must document in your file to start the process. Many times, it is helpful to contact our Rehab office prior to meeting with your doctor to discuss the specific coverage criterion and request a copy of this documentation be forwarded to your doctor prior to your appointment so your doctor is aware of these guidelines. In either event, you need only contact our Rehab office for more information.
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I have Medicare and was wondering what the term “Capped Rental” means?
Capped Rental (CR) is a term used by Medicare to indicate an item will be rented over time - many items such as manual wheelchairs are lumped under this option. The capped rental process dictates that the wheelchair that you receive, minus some accessories such as cushions and other accessories which are paid for right away, will be rented for a period of either 13 months or 15 months. 10 months after you receive your wheelchair, you will receive a letter from Spectrum Medical asking if you wish to purchase or continue to rent the wheelchair you received. Whether you chose to continue to rent or purchase your wheelchair you are entitled to certain benefits that can be explained by either the Patient Billing Services or Rehab Department. If you should be renting a wheelchair under the Capped Rental program and have questions, or would like more information in general, please call for details. Please be aware, this document is time sensitive and you must indicate your wishes within 30 days or the item will automatically revert to a rental option whether or not you had intended for this to occur or not.
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If I recently moved to Montana and have a problem with my wheelchair, will Spectrum Medical help me fix it?
In short, yes. Spectrum Medical will assist you in the maintenance of equipment purchased from other vendors and for those persons relocating into our service area. Certain documentation will be required from the original provider prior to service but in many cases this can be obtained with a properly completed Information Release form. Give us a call, our responsive, knowledgeable Rehab Department will be happy to assist you in getting this process started!
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I’m interested in having Spectrum Medical help me get my wheelchair but live outside of Great Falls, will you come out to my home to meet with me?
Yes, our Rehab Department covers a large area on a regular basis and would be happy to assist you with your mobility needs in your home. Our coverage area is shown below (shaded green area) and references the general borders we travel If you have a need, give us a call and we will connect you with the dedicated staff to get you up and going.
