AT KERN MEDICAL SUPPLY, we care for your Patients.
As a locally owned and operated company, our team of local, dedicated experts is genuinely committed to the communities that we serve. Our team is comprised of:
Help your patients get the equipment they need
We are a full-service DME provider. Now more than ever, it is evident that caring for a loved one at home is right where we want to be. We help provide the tools for your patients to age at home and maintain their independence safely and affordably. Explore the various products we offer, and utilize our insurance coverage resource to view the paperwork requirements.
**Referring a patient for a custom wheelchair in Kern County**
A standard wheelchair order and a custom wheelchair referral are not the same paperwork. A standard chair can be a set size from a catalog or a rental. A custom chair is configured after a seating evaluation: the frame, the cushion, and often a molded seat. If your patient will live in the chair, has a posture that a stock seat will not hold, or is a child who will outgrow a fixed size, send them for that evaluation instead of a shelf chair.
**Who this is for**
Physicians, physician assistants, nurse practitioners, and therapists in Kern County who write the order and choose the supplier. The patient, or their family, has usually been told to ask you which company to use.
**What to send**
Send the referral to Kern Medical Supply and include:
– The face-to-face encounter note.
– A standard written order for the mobility device.
– The diagnosis and why a standard chair will not meet the need. That is the start of medical necessity. The letter of medical necessity is often completed with the therapist after the seating evaluation, not instead of the visit.
– Any recent therapy notes if a physical therapist or occupational therapist is already involved.
**What Kern does after the referral**
An Assistive Technology Professional measures and configures the chair with the patient, and with the therapist when one is on the order. Kern’s complex rehab team includes Tracy M. Hughes, ATP, and Mary A. Kaplan, ATP. The visit can be in the clinic’s plan or as a free in-home consultation in Kern County. The patient can also book from the schedule form if you want them to start there.
After the evaluation, the equipment quote and the letter of medical necessity go with the order into funding review. Do not promise the patient a week count. The timeline depends on the evaluation, the records, the authorization, and the build. Kern will give a timeline for that order.
**What to tell the patient**
Tell them a custom chair is not picked off a website, and it is not a same-week purchase. Tell them to bring their insurance card and to be ready to say what the current chair, or the lack of one, keeps them from doing. If they ask you to name a supplier, you can name Kern Medical Supply and send the records above.
**What this referral is not**
It is not a repair request. Repairs have their own page and their own timing. It is not a rental for a short recovery unless you only need a standard chair for a short time. Those are on the rental and standard wheelchair pages.
To send a patient, use the physician resources page or call the office and ask for complex rehab. The patient can book the visit at the schedule form while you send the records.
DME prescription requirements
A DME prescription, sometimes referred to as a Standard Written Order (SWO), must be signed and dated by a treating practitioner, which can include a physician, physician assistant, or nurse practitioner.
The order must include:
- Patient information: Name or Medicare Beneficiary Identifier (MBI).
- Item details: A general or specific description of the equipment, including any separately billed accessories.
- Quantity: If applicable, the number of items to be dispensed.
- Practitioner information: Name or National Provider Identifier (NPI), and signature.
- Date: The date the order was written.
Pre-authorization and medical necessity
For most DME, especially for Medicare and Medicaid patients, additional steps are required to establish “medical necessity” and receive pre-authorization from the insurance provider.
- Face-to-face encounter: For certain items, a visit with the patient within six months of the prescription is required to gather subjective and objective clinical information. Documentation of this visit must be kept in the patient’s medical record.
- Supplier coordination: The DME supplier often works with your office to complete the prior authorization request, but you must provide the necessary clinical documentation.
- Medicare Advantage: For patients with Medicare Advantage, you may need to refer them to a specific DME supplier within their plan’s network.
- Original Medicare: Patients with Original Medicare will need to use a Medicare-approved supplier. The supplier must accept assignment to ensure the patient is only responsible for the deductible and coinsurance.
Resources for providers
- DMEscripts: This is a free electronic prescribing service that allows practitioners to send DME orders directly to suppliers. It automatically gathers necessary patient and qualification information, helping to streamline the ordering process.
- CMS DMEPOS information: The Centers for Medicare & Medicaid Services (CMS) offers extensive resources on the rules and requirements for DME, prosthetics, orthotics, and supplies (DMEPOS). This includes requirements for the written order and documentation.
- Provider manuals: Health insurance plans, including state Medicaid programs like Medi-Cal, publish detailed provider manuals that outline their specific DME pre-authorization procedures and covered items.
Referral process overview
1. Meet with the patient: Conduct an in-person or telehealth visit and document the patient’s medical condition and need for the equipment.
2. Write the prescription: Create a complete Standard Written Order (SWO) that includes all the necessary components.
3. Coordinate with a supplier:
a. For patients with Medicare or Medicaid, refer them to a DME supplier who is enrolled with Medicare and participates in their plan.
b. For other insurance, refer the patient to a supplier within their plan’s network.
4. Submit documentation: Provide the SWO and all supporting medical records to the DME supplier. For some insurers, you or the supplier will need to submit a Treatment Authorization Request (TAR).
5. Follow up: The DME supplier will arrange for delivery and fitting. If there are delays or a denial, review the documentation and appeal as needed.
We provide financing for all products including mobility scooters. 0% financing options available on larger purchases.
We take most insurance!
What information is needed
to get items covered for my Patients?
Our insurance page is comprehensive and easy to use, providing itemized instructions on the coverage approval process. Kern Medical Supply, LLC associates are committed to offering guidance from start to finish, helping alleviate the burden for both physicians and patients.
We conveniently provide delivery and pickup services
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