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QUALIFYING CRITERIA FORMS

Thank you for downloading these qualifying criteria forms! Insurance companies provide guidelines that must be met if they will consider payment for a product. We are obligated to follow these guidelines in order for the customer to have their products “covered” by their medical insurance. Insurance companies will not guarantee payment until the claim has been processed. In addition, there may be a deductible and/or co-insurance requirements that will affect payment. It has become increasingly more complicated to meet the standards of the insurance companies. Customers can always waive their insurance benefits and choose to privately pay for products. These qualifying criteria forms are based on the information that Medicare requires. While some insurance companies may request more; these cover the basic information that is required.

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Walker request form

When a walker is needed, this form will help guide you through the information that is needed for most insurance companies. Handi Medical Supply carries many types of walkers, folding, 4-wheeled and an assortment of colors. For those you live in certain areas, this is a competitive bid product through Medicare.

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Lift Chair

A lift chair provides safety, comfort and ease of rising from a sitting to standing position. This form helps identify if your insurance company will help pay for the lift mechanism. Most insurance companies will not pay for the furniture portion of the chair, unless you have Medical Assistance. For those you live in certain areas, this is a competitive bid product through Medicare.

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Standard wheelchair

Wheelchairs are one of the most effective ways to safely navigate distances. Most insurance companies require you to meet certain specifications; this form will guide you. If you are going to be spending hours in the wheelchair, you should consider a cushion and comfort back. For those you live in certain areas, the lift portion of a lift chair is a competitive bid product through Medicare.

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Patient Lift

Patient lifts safely move and transfer you from one surface to the next. Whether it is a sit-to-stand lift or a non-weight bearing lift; this completed form will assist your insurance company in determining if you qualify for it to be a covered benefit. For those you live in certain areas, this is a competitive bid product through Medicare.

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Electric hospital bed

There are many types of hospital beds, including hi-low and bariatric. Hospital beds come in manual, semi-electric and full electric. This form will indicate which type of bed your insurance will allow. For those you live in certain areas, this is a competitive bid product through Medicare.

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Support Surfaces Group I

Whether you require a preventative mattress to reduce the risk of pressure injury or a therapy mattress to treat wounds, Handi Medical Supply has the products to meet your needs. From mattress over-lays to replacement mattresses, including low air loss systems, our team will assist you. For those you live in certain areas, this is a competitive bid product through Medicare.

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Support Surfaces Group II

Whether you require a preventative mattress to reduce the risk of pressure injury or a therapy mattress to treat wounds, Handi Medical Supply has the products to meet your needs. From mattress over-lays to replacement mattresses, including low air loss systems, our team will assist you. For those you live in certain areas, this is a competitive bid product through Medicare.

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Oxygen

Most insurance companies require that you qualify for oxygen therapy, as oxygen is a drug. This completed form will allow us to make sure that oxygen will be paid for by the insurance company. Handi Medical carries portable oxygen concentrators; our clinical team can help with selection. For those you live in certain areas, this is a competitive bid product through Medicare.

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Nebulizer

In order to aerosolize pulmonary medication, a nebulizer is needed. We have small nebulizers, including pediatric fun character machines. For those you live in certain areas, this is a competitive bid product through Medicare.

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Enteral Nutrition

Food and food delivery, whether it is gravity fed or through a pump, Handi Medical carries all of the name brand of formula. For those you live in certain areas, this is a competitive bid product through Medicare.

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Pneumatic Compression

Electricity powered pneumatic compression and their inflatable sleeves assist to improve circulation in limbs. There are very specific criteria that insurance companies have to allow the rental of a compression pump and the purchase of the sleeves.

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Urological

Catheters, whether it is an indwelling, intermittent, external and their related supplies, are all available at Handi Medical Supply. All name-brand products are available in our warehouse for you to choose from.

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Ostomy

To better serve you, we work closely with the manufacturer’s representatives to learn about all of the new products that are released. Whether you need a one-piece, two-piece or a host of accessories, we carry them for you in our warehouse.

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Wound Care

From simple gauze and tape to advanced wound healing dressings, your wound healing and comfort is our goal. Insurances require detailed wound documentation and chart notes to pay for wound care.

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Cough assist

When you don’t have the strength or muscle to do so, a cough assist machine stimulates a cough. The cough assist clears secretions from the lungs by gradually applying positive air pressure, then shifting to negative pressure.

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Negative Pressure Wound Therapy

The Sanity G6 NPWT is a light weight (1.8 ib.), quiet and has two patented features:

  • Patented vacuum pump integrated with canister to improve infection control and reduce odors.
  • Patented venting system keeps tubing clear and bioburden out of the wound. Long, 30-hour battery life.
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TENS unit

Transcutaneous Electrical Nerve Stimulation devices work by sending stimulating pulses across the surface of the skin and along nerve strands to reduce pain. For those you live in certain areas, this is a competitive bid product through Medicare.

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Neuromuscular Stimulator

Neuromuscular electrical stimulation (NMES) is a non-invasive, non-addictive way of muscle rehabilitation after injury, surgery or disease.