In 2015, Houston Methodist Hospital, a non-profit corporation in Texas, developed a Functional Mobility and Wheelchair Assessment Form to proactively address requests for further information and denials that they were receiving on Complex Rehabilitation Technology orders for their Medicare clients.
Houston Methodist Hospital offers the copyrighted form free of charge
to any therapist to utilize in their practice. Through utilization of this Functional Mobility and Wheelchair Assessment Form, Houston Methodist Hospital, as well as other independent clinicians and hospitals that have adopted it, have seen a drastic decrease in clinical documentation denials. A decrease in denials translates to decreased documentation reworks and ultimately a faster turnaround on equipment for clients
Where can I find this form and more information?
Numotion, under a copyright and license agreement with Houston Methodist Hospital, has a free, fillable PDF copy available for download
here on our website as well as a tutorial video below, explaining each section of the form, as well as its history, with one of the form authors, Pam Glazener, OT, sponsored by Houston Methodist Hospital.
For additional questions, please feel free to contact (314) 715-4908.
Houston Methodist Functional Mobility & Wheelchair Assessment