Insurance Requirements

• A face to face appointment with your primary care physician (DO, MD, PA or NP) for a mobility evaluation is required. At this evaluation, mobility inside the home must be discussed. Your physician must first consider the use of a cane or walker before considering a manual wheelchair, mobility scooter or power wheelchair. If your physician feels that your mobility needs must be resolved with a manual wheelchair, mobility scooter or power wheelchair, this must be supported in the office notes/medical records from the mobility evaluation visit appointment.

• Objective measurements of physical limitations must be documented to support the need for equipment. Objective measurements include upper and lower extremity strength scales, pain scales, history of falls, gait and balance and coordination.

We do not have any forms that the physician would complete. All of the requirements must be documented in the office notes from the mobility evaluation visit.

• Have your physician fax the office notes and a prescription (standard written order- see below), from the mobility evaluation appointment to Amigo Mobility Center.” We will review the documentation and use it to help determine the appropriate manual wheelchair, mobility scooter or power wheelchair to meet your mobility needs inside the home.

          Bridgeport FAX (989) 921-5082 | Grand Rapids FAX (616) 361-7561

• A consultant will come to the home and complete an in-home assessment/evaluation. The consultant will measure the doorways to make sure the manual wheelchair, mobility scooter or power wheelchair will fit inside the home and be appropriate to meet your mobility needs inside the home.

• Amigo Mobility Center will gather all of the necessary paperwork to submit for a prior authorization to the insurance. Once approved, the appropriate equipment will be ordered and delivered to the home.