Insurance Guidelines / Requirements

The physician must a complete a mobility evaluation / face-to-face encounter and document the support of the mobility equipment that is being prescribed for inside the home. Forms are not accepted.

The links below include a blank prescription form and insurance guidelines of what items need to be documented within the office notes of the mobility evaluation.

• Standard Written Order (prescription form)
• Manual Wheelchair
• Mobility Scooter / Power Operated Vehicle
• Power Wheelchair

A specialty evaluation (Seating/Mobility Evaluation) may be required depending on the insurance and the type of mobility equipment the physician is prescribing. 

Durable Medical Equipment Process (physicians)

• Fax customer referral face sheet (to include customer’s contact and insurance information) to Amigo Mobility Center at 989-921-5082.
• Amigo Mobility Center verifies insurance and contacts customer to schedule the in-home evaluation.
• Once mobility evaluation is completed, the office notes can be faxed to Amigo Mobility Center at 989-921-5082.
• Once reviewed, the remaining documents will be faxed to the office to be signed/dated by the physician who completed the mobility evaluation.
• Amigo Mobility Center will review all the paperwork and will submit to the insurance for prior approval.
• Once approved, Amigo Mobility Center will deliver the mobility equipment to the customer at their home.

Customer Checklist

• Amigo Mobility Center verifies your health insurance.*
• Schedule a “mobility evaluation” with your family physician / primary care physician (PCP) and inform Amigo Mobility Center when this appointment is scheduled for.
• Amigo Mobility Center performs the “in home evaluation” to ensure equipment will fit within the home.
• Amigo Mobility Center will collect the paperwork from your physician and review it. Please note this may take some time. 
• Once all paperwork is received and reviewed, submitted to insurance and a response is given, our staff will let you know the status.