Documentation

• Before you can qualify for AT, you must have a diagnosis that is appropriate to your condition and needs. People who need AT often have more than one diagnosis. It is crucial that the proper diagnosis be used when documentation for AT is being completed. For example, consider a patient who has a developmental disability and lower-limb atrophy. If an application is being made for a wheelchair, the lower-limb atrophy diagnosis must be included prominently; if only the developmental disability diagnosis is used, the application will certainly be delayed, if not denied. Also crucial is that the diagnosis be properly coded; diagnoses are entered into various computer systems by numeric codes. Having a number wrong in the code can create delays. Your doctor's office will also prepare a justification statement, which is a statement of need that provides information about your condition and how the AT you are seeking will improve your quality of life. Justification statements require specific codes and terminology as well as your doctor's signature.
  
  

Private Insurance

• Private insurance often covers the cost of AT. Read your policy carefully, so you understand the details of what your policy covers and any restrictions or limitations. Some insurers use the terminology "durable medical equipment" or DME to refer to AT, while other insurers have other terminology. Knowing the language your insurer uses will help you through the process. Many insurers have representatives who will work with you as you go through the process.
  
  

Medicare and Medicaid

• Medicare and Medicaid are administered by the government, and they too sometimes cover AT. Medicare may have specific requirements that must be met to qualify for certain types of AT. For example, if you need a wheelchair because you have emphysema, you may have to have a certain score on lung-function tests to qualify.
  
  

Donations and Foundations

• A number of organizations provide AT at a reduced cost and sometimes for free. Many organizations help fill the gaps when AT is needed and there is no insurance coverage to pay for it. Some organizations work only with specific conditions or diseases, such as the Muscular Dystrophy Association (MDA) or a certain segment of the patient population, such as the National Organization Caring for Kids (NOCK).