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  • I want a roho prodigy

    I want a roho prodigy matress. problem is 4 medicare contracted supplies do not carry roho products. what do i do.
    Wish I didn't know now what I didn't know then.
    Bob Seger

  • #2
    Originally posted by tvot View Post
    I want a roho prodigy matress. problem is 4 medicare contracted supplies do not carry roho products. what do i do.
    Maybe your best shot is getting a physician, possibly with the input of a physical therapist, to recommendation, write a prescription and make a good medical case that the Roho mattress (and no other) is what is required for your situation. But, Medicare is pretty rigid and going out of network to a non contracted supplier is an uphill struggle.

    What mattress options are offered by the 4 Medicare suppliers you have to work through?

    Comment


    • #3
      Are you using regular Medicare, or a Medicare HMO (which restricts your DME options)??

      Find a dealer: https://permobilus.com/product/rohop...verlay-system/

      Here is the decision tree for Medicare payment for this product. You do need a prescription that entails these issues for Medicare payment: https://www.rehabmart.com/pdfs/medic..._home_care.pdf

      Tons of on-line dealers, here are just a few:

      https://www.rehabmart.com/product/pr...y-roho-60.html

      http://www.etennurologicalsupplies.c...prodigysys.htm

      https://www.usmedicalmobility.com/cr...uctId=19641480

      https://www.hutchinsonmedical.com/th...ductid=4652546

      (KLD)
      The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

      Comment


      • #4
        Originally posted by SCI-Nurse View Post
        Are you using regular Medicare, or a Medicare HMO (which restricts your DME options)??

        Find a dealer: https://permobilus.com/product/rohop...verlay-system/

        Here is the decision tree for Medicare payment for this product. You do need a prescription that entails these issues for Medicare payment: https://www.rehabmart.com/pdfs/medic..._home_care.pdf

        Tons of on-line dealers, here are just a few:

        https://www.rehabmart.com/product/pr...y-roho-60.html

        http://www.etennurologicalsupplies.c...prodigysys.htm

        https://www.usmedicalmobility.com/cr...uctId=19641480

        https://www.hutchinsonmedical.com/th...ductid=4652546

        (KLD)
        As I understand Medicare, you cannot go to a non Medicare provider, (do these only line providers accept bill Medicare and accept Medicare pay as payment in full), buy the mattress, and then expect reimbursement. Been there...done that. lost 4 rounds of appeal on a piece of durable medical equipment.

        Comment


        • #5
          Originally posted by gjnl View Post
          As I understand Medicare, you cannot go to a non Medicare provider, (do these only line providers accept bill Medicare and accept Medicare pay as payment in full), buy the mattress, and then expect reimbursement. Been there...done that. lost 4 rounds of appeal on a piece of durable medical equipment.
          You are correct. The DME companies I posted all will take a prescription and bill Medicare as long as the prescription (actually, letter of medical necessity) includes the Medicare indications listed. There are many others that will as well. If tvot has a Medicare HMO though, this may severely limit the DME companies he can use. One of the reasons I did not sign up for a Medicare HMO, personally!


          (KLD)
          The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

          Comment


          • #6
            Originally posted by gjnl View Post
            Maybe your best shot is getting a physician, possibly with the input of a physical therapist, to recommendation, write a prescription and make a good medical case that the Roho mattress (and no other) is what is required for your situation. But, Medicare is pretty rigid and going out of network to a non contracted supplier is an uphill struggle.

            What mattress options are offered by the 4 Medicare suppliers you have to work through?
            well a therapist started helping today. she got as far as i did. my opinion is they don't sell roho because of a low profit margin. just let me say this. it was so much easier years ago and it will be a cold day in hell before i get a different mattress. DON'T MESS WITH SUCCESS!
            Wish I didn't know now what I didn't know then.
            Bob Seger

            Comment


            • #7
              tvot, are you restricted to those companies by your insurance? See discussion above.

              (KLD)
              The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

              Comment

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