| |||||
|
Medicare Billing for Wheelchairs & More
Avenue Medical and Medicare As a full service medical equipment supplier. Avenue Medical is an authorized Medicare provider, and we are happy to assist you in obtaining reimbursement from Medicare for any eligible item(s). Medicare normally pays 80% of an allowable amount, which varies by state and product category. Generally, Avenue Medical prices are well below the allowables for most eligible products. Most likely, you will be reimbursed at 80% of the Avenue Medical price. Discounted prices can save you significantly on your 20% co-pay. Please call our customer service at 1-800-541-8119 to determine the allowable amounts for the item(s) you are purchasing. Avenue Medical is only able to process claims for customers that have non-HMO Medicare as their primary coverage. An HMO is a secondary company whose services have been enlisted to manage your Medicare coverage and benefits. Avenue Medical will verify your coverage and eligibility before processing your order. Medicare assigned billing for Power Wheelchairs: Avenue Medical will accept assignment on a select list of power wheelchairs. We will gather all the necessary paperwork and then provide you with an appropriate power wheelchair and bill Medicare. You would be required to pay your 20% co-pay. If you have secondary insurance we may be able to bill that as well, making your new power wheelchair available at little or no cost. Medicare courtesy billing for Power Wheelchairs, Ultra lightweight Wheelchairs, Scooters, Lift Chairs, Walkers and Cushions: For most items, including most power wheelchairs, ultra lightweight wheelchairs, scooters, cushions, lift chairs and walkers Avenue Medical provides what is known as "courtesy billing", also called "non-assigned" billing. Courtesy billing means you purchase the equipment from Avenue Medical, and Avenue Medical handles all of the paperwork to submit a claim to Medicare on your behalf. This includes any paperwork needed from your physician. If Medicare approves your claim, Medicare will reimburse you directly. Lift Chairs For lift chairs, Medicare will only cover the seat lift mechanism, but not the actual chair itself. The reimbursement amount is roughly $300 depending on the state in which the patient is located. A lift chair would be considered medically necessary if all of the following coverage criteria are met:
Wheelchair Cushions For wheelchair cushions, Medicare requires that Avenue Medical submit the manufacturer, the model, and the date of purchase of the wheelchair. Please send in this information along with the prescription. Power Wheelchair and Scooter Coverage Criteria The beneficiary may qualify for a power wheelchair or scooter if the following general criteria are met:
| |||||
| |||||
