Abstract
Objectives Power mobility devices (PMDs) such as power wheelchairs and scooters are crucial for mobility, self-care, employment, and leisure activities. The documentation process for insurance coverage is complex and requires communication and document delivery among multiple stakeholders. The objective of this project was to develop an electronic submission process for medical documentation of PMDs submitted for prior authorization to a Medicare Administrative Contractor (MAC) and implement a standardized means of communication between providers and payers.
Methods A protocol was developed to create and securely transmit an electronic prescription and several documents that outline medical necessity from a clinical team using EpicCare to a MAC via a Health Information Handler. A Rehabilitation Technology Supplier (RTS) added detailed product information and specifications to the electronic package during transmission.
Setting The setting involved in the study was University-based outpatient assistive technology clinic.
Results The protocol demonstrated successful transmission of an order, medical documentation, and request for signature. Results were transcribed to a readable format for the clinical team and RTS. A set of quality metrics for use in future projects was also identified.
Conclusion This pilot project demonstrated successful electronic exchange and transmission of medical documentation for durable medical equipment from the electronic health record to a MAC.
