EXPERT CARE COORDINATION | Getting the Right Equipment and Supplies
Filling the gap between knowledge and care
For someone with a spinal cord injury, MS, or another disability that affects their bladder function, not having the right catheter, or enough catheters, can land them in a hospital with a potentially deadly infection. If a person’s bath chair, specialized bed or lift is broken, not being able to get it repaired or replaced can quickly harm both their physical and emotional health.
Unfortunately, most insurers and healthcare providers have little knowledge of how important the right equipment and supplies are for the health of someone with a physical disability. One of the most important things ICS does is help to fill that gap in knowledge and care.
ICS experts have decades of experience helping people with physical disabilities get the right equipment and supplies to help them be as healthy and independent as possible.
Often, someone with a disability is denied a necessary piece of equipment or an essential supply simply because the required documentation is complicated or because the person’s insurer believes the item isn’t covered. For example, insurers often refer to Medicare guidelines, which are more restrictive than Medicaid guidelines, when determining what is covered, despite the fact that all ICS members have Medicaid. This can result in the denial of equipment or supplies to which a member is, in fact, entitled, and which they need.
In other cases, a medical provider may be unfamiliar with exactly how the person’s disability affects their needs or the correct item to prescribe. ICS staff are expert at navigating these situations, clarifying what items work best to protect the individual’s health, explaining insurance guidelines and necessary documentation, and providing billing codes to assist the member in getting what they need to stay healthy.
In addition, sometimes when a supplier doesn’t have a particular item or believes it isn’t covered by insurance, they will send a substitute that doesn’t meet the individual’s need. ICS can intervene in these situations to either show that the item is covered or to determine an appropriate substitute so that the member doesn’t wind up with something that puts their health at risk.