Insurance Information
For custom manual wheelchairs, power scooters, and power wheelchairs
Insurance requirements and steps for custom manual wheelchairs, power scooters, and power wheelchairs:
- Obtain a prescription from your provider for the requested equipment. The prescription must include the item, diagnosis, length of need, and signature of the prescriber.
- ALL insurance companies require the patient to complete a seating/mobility assessment by an OT/PT. Kohll's Rx will help assign an OT/PT to your case if you currently do not see an OT/PT. There are no exceptions on skipping this step. If this step is not completed, the request is automatically denied by insurance companies.
- A face-to-face appointment with the provider is needed in order to discuss the findings of the evaluation, and for the provider to provide office notes to discuss the requested device. During this appointment the doctor will review and sign the assessment from the OT/PT, provide office notes, provide an updated prescription if needed, complete a 7-element form, and complete the detailed product description from. Once completed they will fax the paperwork to 402-408-1085.
- Once the paperwork is completed, it will be sent to the insurance company for prior authorization in which a review and decision making will attempt.
- If approved, you will be contacted and advised of the approval. You will be advised of how the insurance will pay for the device, how much they will pay, and if you will owe any portion of the cost. The item will then be ordered if not already on the floor, and then scheduled for delivery once the item is ordered. Please keep in mind any custom device cannot be ordered until there is an approval due to the device being custom to each individual. Any item ordered can take up to 2-3 weeks to arrive at the store.
- If denied, you will be contacted with options to appeal the denial or to pay out of pocket for the device.
For standard, basic manual wheelchairs
Insurance requirements/steps for a standard basic manual wheelchair:
- Obtain a prescription from your provider for the requested equipment. The prescription must include the item, diagnosis, length of need, and signature of the prescriber.
- The provider will need to complete a physician's order and provide office notes as to why the wheelchair is needed. The provider will be sent a blank physicians order form and a chart note guideline sheet that contains six (6) questions that are required by ALL insurance companies to include in the notes.
- Once paperwork is completed and meets the insurance requirements, then delivery will be set up. Some insurance companies do require prior authorization in which an approval will need to be obtained before we can deliver the chair.
- If you have Nebraska Total Care or Iowa Total Care, they will require a wheelchair assessment to be completed if the device is needed for more than three (3) months. The mobility team will assist you.