The order process from initial evaluation to delivery of your equipment is complex and involves multiple parties within and outside of Numotion. Given requirements for documentation, as well as prior authorization, the process can take some time. We will do all we can to optimize the process and reduce the time involved and we will do our best to keep you apprised of your order.
See the sample timeline so you can understand the process.
Seating and Mobility Assessment
Our ATP will meet with you, and/or your caregiver, to provide an assessment of any seating, positioning and mobility needs. This is one of the most important steps in ensuring you are provided with the right mobility solutions to fit your needs. The full assessment includes a clinical evaluation, physical assessment and measurements of the portions of your body relevant to your seating needs.
Clinical Evaluation
The clinical evaluation is important in determining your mobility goals. During this process, your clinical team will document your medical and surgical history and have a conversation with you regarding your specific situation and needs.
Physical Assessment
The physical assessment often begins with a mat evaluation, where you will be assessed out of your wheelchair on a mat. During this evaluation, an occupational or physical therapist will test your functional mobility skills as well as test skills related to your activities of daily living (ADL). Your ATP may also use trial equipment when appropriate to evaluate how different technology can best aid in your mobility.
In addition, your ATP and clinical team will assess your balance and may utilize a seating tool called “pressure mapping.” This aids in the evaluation and selection of seating solutions and helps identify any points of contact that may be highly susceptible to pressure injuries. All the information obtained during the physical assessment helps your ATP and clinical team determine the most appropriate mobility base and seating and how that seating should be optimized with your wheelchair.
Measurements
It is also important for your ATP to take both the linear and angular measurements necessary to design a customized wheelchair and seating system that is specific to your personal and medical needs. Examples of linear measurements include trunk and thigh depth, hip and knee width and elbow and lower leg height. It also includes more complex measurements like thigh to trunk angle and thigh to lower leg angle.
Additional Resources
NuDigest: Purpose and Process of a Clinical Seating Evaluation for a CRT Device
NuDigest: Are Community Based Seating Clinics the Future?
NuDigest: Benefits of Standing
NuDigest: Posture and Visual Development
NuDigest: The Mathematics of Complex Rehab Seating
NuDigest: The Hands-On Mat Evaluation for the Complex Rehab Client
Product Selection
The in-depth nature of the evaluation allows the Numotion ATP to determine the optimal technology to fit the needs of the patient and make recommendations. From there, in collaboration with the other members of the clinical team, the appropriate medical documentation is created to continue with the order process.
For more advanced complex mobility products Numotion may be able to provide equipment for an in-home trail or for trial at a clinic to ensure the right product is selected for you. Ask your ATP for details, or contact one of our
Numotion locations.
Additional Resources
NuDigest: All Manual Wheelchairs Are Not Equal
NuDigest: Balancing Loaner Wheelchair vs Custom Wheelchair Needs for ALS patients
Nu Digest: The Basics of Getting Your Client in Powered Mobility
Nu Digest: Selecting the Right Wheel Configuration for a Powered Wheelchair
What is Medical Documentation?
During the medical documentation phase, the Numotion team ensures that all of the correct forms are properly completed and all requirements as outlined by your payer and the state in which you live are met. These forms are then reviewed by your physician who documents agreement with the evaluation and corresponding alignment of medical necessity to the suggested equipment based on your medical history and current condition. If the physician agrees with the recommendations of the ATP and clinical team, the order proceeds. If there is an issue or clarification is needed, Numotion works with the physician to address all concerns and make necessary adjustments.
Once medical documentation is finalized, the order is submitted to the funding source for approval.
Additional Resources
NuDigest: Clinical Criteria Algorithm - Wheelchair Prescribing for Medicare Beneficiaries
Explaining the 7 Element Order: Required Documentation for Medicare-Funded Power Mobility
NuDigest: The Complete Face to Face for Medicare Power Mobility: Required Documentation for Medicare Funding and the Denial Risk of Duplicating Effort
What Happens at Funding Approval?
At this stage, the order is with your insurance provider who checks that:
- Proper documentation has been provided in the correct manner
- There is sufficient medical necessity
- All criteria is met for this to be a covered benefit
If all the above is in place your order will be authorized for funding and move to the next step. If your order is denied for a technical issue, Numotion will be notified and will work to correct these issues and resubmit for approval. If your order is denied on a medical necessity basis, there is a series of appeals that can take place in an attempt to secure approval. Your Numotion ATP and order processing team will support the appeals effort and resubmission process as necessary and applicable.
Assembly, Delivery, Fitting and Training
When your order is fully approved, Numotion places an order for the equipment components with our manufacturing partners and assembles your individually configured product. When ready, your ATP will work with other Numotion professionals, including seating technicians, to deliver your prescribed mobility products right to your home or during a clinic visit. At delivery, we will make sure all your mobility products are fit and adjusted to meet your individual needs. We will also work with you, and your caregiver(s), to make sure there is sufficient understanding of all the product features, including safety and maintenance.
Additional Resources
NuDigest: The Case for Home Delivery
NuDigest: Training Methods for Pediatric Powered Mobility
NuDigest: Addressing Parent’s Perception of Powered Mobility
NuDigest: The Importance of Properly Programming Powered Wheelchairs