We work very closely with the DME (durable medical equipment) suppliers to help you get your equipment but we are two separate companies. (see partner logos for a few companies we work closely with). Legally we have to be 2 separate companies for the reasons described below in the second question and answer. We do not sell wheelchairs; we are a therapy company that specializes in therapy wheelchair assessments and training. You need both a therapist AND a DME supplier to get your equipment.
The role of your therapist is threefold:
Here is a description of the role of a therapist from one wheelchair user:
“I’d ditched the seating clinic after my previous experience, and on a friend’s recommendation, had found a new PT. I met with my new therapist… We made a few minor changes based on the therapist’s recommendation, and overall, the process was a breath of fresh air. I felt empowered rather than dictated to… The appeals process is another reason that it’s so valuable to find a therapist who is both knowledgeable … and passionate about getting you the equipment you need. Insurance appeals are designed to make things tedious and opaque, to take forever and grind you down until you just accept what they’re offering. A therapist is usually the grunt worker through the process because they have the knowledge to argue about “medical necessity.” To be an effective advocate, they have to have an in-depth knowledge of both SCI and your individual situation, as well as the willingness to engage in a protracted battle…. Find a PT and an ATP [DME supplier] who are willing to fight for what you need. Don’t let the vendor [DME supplier] dictate the process.”
Historically, there were some DME suppliers that sold patients equipment that they didn’t need or that wasn’t the right equipment for them. Many years ago, insurance companies began to require a therapy assessment to make sure the equipment is medically necessary and going to work for the patient.
In order to get equipment, you, your therapist, your DME supplier, and your doctor each need to do their part. At Life Wheels On, our therapists complete their paperwork typically in < 3 days and send it to your selected DME supplier. After our recommendations are sent, it is up to you, your DME supplier, and your doctor to complete the insurance paperwork requirements. Some of our patients receive equipment in 30-90 days and other take longer because of the variables mentioned above. Our therapists work very hard to ensure that we are not holding up the delivery process because we know how badly our patients need their equipment.
If you only need a wheelchair for short period of time, we recommend you go directly to a DME supplier contracted with your insurance for a generic, one size fits most, wheelchair. If you need to use a wheelchair (or other mobility equipment) for a long term need or on a regular basis, we recommend you have a specialty therapy assessment to get the equipment that is right for you.
Our services are billed to insurance as outpatient therapy. For many of our patients there are no out of pocket costs. If you have Medicaid there are no out of pocket costs. If your insurance has a therapy copay or deductible, you will be responsible for those costs as indicated by your policy.
Our model of care is very patient centered. As the wheelchair user mentioned above, we seek to empower, not dictate recommendations to our patients. Our therapists are trained to know what questions to ask to help you get the best possible equipment for your needs. We keep you at the center of the process since you are the one using the equipment. Bad experiences with poor outcomes often occur from evaluations that were rushed and didn’t allow time for equipment trials or a thorough assessment. Other times a bad experience occurs when a supplier or therapist did not know what questions to ask or did not listen well to the patient. Our goal is to operate as quickly as possible without sacrificing quality of care and taking the time to listen to our patients. It is only with good listening that we can help you get the right equipment that will work best for you.
You are putting yourself at risk by working with a therapist without experience and training in this area. There are many cases of poor outcomes from unspecialized therapists performing a specialty wheelchair assessment. One patient worked with an outpatient therapist she was already seeing for balance problems, ended up getting the wrong wheelchair for her needs, and had to pay out of pocket to have it corrected. She came to see us for an assessment only after the first one didn’t go well. This could have been avoided with a quality assessment the first time.
Any therapist is licensed to complete the paperwork but few therapists have the experience and specialty training necessary to get the best outcomes for the patient. All therapists at Life Wheels On either have their Assistive Technology Professional (ATP) certification or are working towards it.
Even Medicare requires “a PT or OT, who has experience and training in mobility evaluations to perform part of the face-to-face examination.” This requirement is frequently overlooked and general therapists often perform the evaluation instead of ones with experience and training in mobility evaluations and it is the patient who suffers as a result.
You need to have your paperwork filled out and ready so your therapist can spend the appointment focused on you and not on paperwork. The therapist will want to see any current equipment you have and will ask you questions about your goals and your mobility. If you are able to walk, the therapist will watch you walk a short distance. There is very little physical movement during the appointment and most patients experience little to no pain from the assessment. The majority of the session(s) is question and answers getting to know you and your needs.
We can make recommendations for your home modifications for wheelchair use. If you have Medicaid, we can work with your service coordinator to help get your modifications paid for. If you do not have Medicaid, we can make recommendations and provide you with some options of contractors who specialize in this area (see partner logos).
Life Wheels On offers a combination of home and/or clinic appointments. There are several benefits to appointments in a clinic as there is more equipment available to trial, it is easier to obtain more accurate measurements with firmer surfaces, and more tools are available for on-the-spot equipment adjustments as needed. However, if leaving your home is very difficult for you, we will do our best to complete the assessment in your home.