Subject: Re: help with funding for mattress -- funding through Medicaid denied
From: Chris Clark (ceclark@cet.com)
Date: Tue Sep 24 2002 - 20:08:45 PDT
Concerning the extra-firm mattress funding,
I wonder if any of the medical supply businesses in this gentleman's
community has obtained insurance payment for a similar prescribed
mattress. I wonder what were the requirements for the approval.
What other treatments or equipment are available for this person's
condition. Have all other remedies been tried with no significant
improvement?
Have the physician and the physical therapist requested a consultation
with the medical director of the Medicaid unit?
If the refusal was in writing, the advocates for this person, could help
file a fair hearing request.
Usually DSHS will request a detailed explanation from the doctor and the
physical therapist, request a more extensive evaluation, or request a
second opinion. Some or all of this could be part of the fair hearing
request document.
Sometimes the request for a second opinion by a specialist in this field
will be successful or provide another satisfactory remedy.
Chris Clark, retired? advocate
On Tuesday, September 24, 2002, at 02:35 PM, Ginette Perkins wrote:
> Consumer has arthritis in his back, has a prescription from his doctor
> for an extra-firm mattress without pillow top. Both the doctor and the
> physical therapist highly recommend this for the client. However,
> Medicaid flattly refuses to fund this.
>
> Consumer has a source where he can get the mattress but no funding.
>
> Does anyone know of any other funding sources or any suggestions that
> might help?
>
>
> Ginette Perkins
> Assistive Technology Information & Referral Specialist
> Washington Assistive Technology Alliance
> 1-800-214-8731 (Toll Free)
> (509) 328-9350 (Voice, TTY)
> (509) 326-2261 (Fax)
> ginettep@seals.org
> http://wata.org
>
>
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