I was diagnosed 13 years ago with MS..my mobility is limited and I use a cane to get around. My neuro and physical therapist felt that a scooter would be benefical for my daily living/social recreation..my health insurance has a denied a pre-authorization submitted by a DME company, their reason being that the scooter "is a transportation devise. It does not treat an illness nor serve a medical purpose. It is useful to a person without a disease or disability". They told me that I can appeal their decision but they are now giving me the run around; and get this I work for this same insurance company who insures me. I, in no way want to jeopardize my job, but in order for me to have any "quality of life" beyond the daily grind, I feel that a scooter would help since I can only walk with the cane for short distances.
Any advice or suggestions would be greatly appreciated. I have to write an appeal to the insurance co within 180 days and I am at a loss as to where to begin
Advice needed
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adjanimals
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Did you alone submit a claim or did you doctor write an prescription for one. This is strange that they denied it. I would assume there is a durable equipment in your insurance. When I got my scooter, I called the insurance company and inquired. They said as long as the doctor sent in the prescription and a letter stating the reason, there would be no problem. There was a $2000 cap in my policy so I found a scooter close to that. Oh, make sure the place you want to purchase one, is acceptable with your insurance company. I'm sure you did everything right. Sounds like your insurance company are pricks. Just some thoughts. Good luck to you.
ADJ
ADJ
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HarryZ
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Re: Advice needed
It's amazing how some insurance company reps come up with these ideas and comments!! If a doctor prescribes a scooter for your mobility then the insurance company shouldn't deny it. Then again, you could ask the company if you got a rx for an electric wheel-chair, which is definitely classed as a medical device, would they prefer paying over $ 8000.00 for one of those as opposed to a couple of thousand for a scooter!DME company, their reason being that the scooter "is a transportation devise. It does not treat an illness nor serve a medical purpose. It is useful to a person without a disease or disability
Harry