Dilemma

So. . . you guys remember that I ordered a wheelchair last year? Well, looking back, I can see that I posted on September 29th about our wheelchair decision. Since then, I’ve heard exactly nothing from our wheelchair representative. Not. One. Word.
Today, they called me. A woman asked me, “did you know your insurance doesn’t do pre-approval for blah, blah, blah?” Or something like that. I told her I didn’t even know what that means. Basically, my insurance company doesn’t do pre-approvals for medical equipment. So, you have to order the equipment and hope that they pay for it She also told me that I would have to pay 30% up-front, which is roughly 1700 dollars.
So here’s why I’m upset.

  1. It took them four months to figure this out.
  2. If the wheelchair had been ordered and delivered prior to December 31st, I would have had to pay $0 because we met our deductible last year. I realize that these things move slow, but since the claim isn’t filed until AFTER the chair is delivered, I feel like it was possible to have had the chair ordered quickly.
  3. Back when I ordered the chair, the big dilemma was whether or not to get a tilt chair. According to the rep, the tilt chair didn’t have self-steering wheels. Since then, I’ve had another special needs mom tell me that the newer models have both tilt and self-steering.
  4. I wasn’t given any choices with regards to seating. Barbara at Therextras very adamantly recommends a flat seat, and the rep told me they never do that. This bothered me, but it’s not like I had a lot of options. Actually, I had exactly none, so what are you gonna do?
  5. I Googled my wheel chair and the base model runs about $1600. I realize there’s a lot more to it than that, but it seems like they want me to pay for the entire chair and then they’re going to bill my insurance company another $3700. They’ll be making a pretty sizable profit for some sub-par performance.
  6. I heard through the grapevine that this company is swimming in debt and may go out of business. I’m worried that I get the chair from them and not be able to get any more service for it if they fold.

I feel bad. I mean, a rep came out to my house and measured Charlie and everything, and I’m sure he’ll lose money if I don’t buy the chair from his company. On the other hand, I don’t think I should reward piss-poor performance with our hard-earned money–we don’t just keep it in a tub and roll around in it in our underwear.

A source of mine has given me the name of another wheelchair representative who sells the same brand of chair. Should I just call them?

Has anyone out there ever tried to just buy their own wheelchair off the Internet?

Playing in our very own “Pond.” Idea shamelessly stolen from No Time for Flashcards.

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Comments

  1. Cancel the order and find a new rep. Bad service = no business, at least in my opinion. OR, see if since you ordered it last year (do you have paperwork???) that it can go against last years deductible. It isn't your fault they bill like that, you know? What if you had been planning on it going with your deductible and then were surprised (like you ARE)?

  2. MeghatronsMom says:

    Must be going around. I have a post up about it & haven't gotten around to adding how it is going. Have I mentioned I HATE effing insurance???

  3. Yeah it seems like they are going out of business b/c they suck. I'd go with another company if I were you.

  4. Don't be blackmailed into buying the chair. Yes they are ridiculously expensive and make sure you get growth potential out of the one that you do buy. And so some research into a padded, contured seat. Alan has one and it helps with circulation in his thighs and bottom. Tilt is worth it, and yes it can be moved by one's self.

    Check the BBB and attorney general's office on this place. You can't be too careful.

  5. We got the run-around with one of Max's chairs to the point that rep #1 lost the sale…and we went with the other company. Got the same chair without the hassle.

    I don't know if they could arrange any sort of delivery, but we have an amazing organization here called, Kids Mobility Network that provides equipment to children that can't get it through insurance or medicaid.

    http://www.kidsmobility.org/GetDME.htm

    We have donated several of Max's pieces of DME to them…and our rep volunteers to fit them to the kids.

    You might also talk to Variety, a Children's Charity. They paid for a special chair for Max, his Chill-Out Chair. http://www.usvariety.org/

    I would not go with the company that has been giving you the run-around. In the end, you are the customer…they will have to earn your business.

  6. CAN THEM, Katy! Don't even look back! Believe us all when we tell you this! That is their tough luck. I have been there and we went through similar stuff with Faith's last year. After her paperwork being "lost" twice to denial based on inaccurate info…it was an ordeal. Now, wheelchairs are a different bird (no pun intended) b/c of all the different combinations but Dr. B is right, a firm seat is HIGHLY recommended! Now our last piece of equipment was her new gait trainer (not nearly as many pieces), we went thru the local pharmacy to order it. Let me compare….over 10 months to get her chair….3 weeks to get and have approved her gait trainer! Now we knew what we needed and did lots of research so it was pretty cut and dry. But if you are having difficulties I would dump them and ask around from other parents for good people. Out of maybe 6 or 7 D.M.E providers, the only one we have ever been impressed with the pharmacy of all places! FORGET THEM! Hope you get some answers….

  7. Wherever HE Leads We'll Go says:

    When we ordered Emily's chair back in July, we had a lot of hassles with our company too. Medicaid took forever to do the pre-approval, but I know that a big part of the reason the whole process took so long is because the company dropped the ball on several occasions. When the chair was delivered last week, the rep told me that the pre-approval expired on 2/1 and we would've had to start all over again if we didn't get the chair. I am pretty sure you would have heard about me on the news if that had happened.

    All that to say, go with the other company and don't feel guilty about it for a single second. This is a major purchase and you should feel confident that you are getting EXACTLY what Charlie needs!

  8. When Elisabeth's wheelchair was delivered last week, both of her therapists looked at eachother with amazement and said they had NEVER seen it happen that fast. Funny, because it had been a few months and I thought that was a long time…but I guess in wheelchair time it's speedy!

    And can you believe how much they cost?! Holy moly!

    Anyways, I am thinking that perhaps you should consider going with another company. Good luck and keep us posted on the progress :)

  9. Mamá Terapeuta says:

    If you wanna feel a bit better, we have to buy almost everything on the internet and in the States… living in Chile. We've never seen before what we are buying, have to pay almosr 40% more for shipping and taxes and NO insurance whatsoever cover not even 1%. :)

  10. therextras says:

    (Charlie is sooo cute! Couldn't resist.)

    I know you will decide based on what is best for Charlie.

    (If we were all in a room together I would be raising my fists in the air with everyone else.)

    And what is best for Katy and Dad is best for Charlie. The chair will be a significant part of your daily life for a while. What is the emotional cost to you to see it every day and feel like you were cheated? Only you can decide. Barbara

  11. It's the same story over and over — and it's maddening! I am sorry, I had hoped it would go smoothly for you guys. I agree with everyone else — go to another dealer! We ordered Jack's first chair when he was turning 3 — we didn't see it until almost a year later. Then it was time for another chair and it went more smoothly but there are still things I should have done differently!!

    Good luck and please keep us posted!

  12. MelissaInk says:

    I have never ordered a wheel chair, but I do think that four months to tell you that your insurance won't pre-pay is ridiculous. That's one phone call. That's … maybe … an hour of someone's time.

    I say cancel and go through another company. I don't care if it's a wheel chair or rubber stamp, they don't deserve your business.

  13. Small Town Girl says:

    I have to say CANCEL and move on to another company. Obviously they're not very concerned with your and Charlie's well-being, so why should you be concerned with theirs?

  14. What exactly did they do between Sep 29th and now?? Absolutely nothing, by the sound of it, so I wouldn't feel bad about switching to someone else.

  15. I am so thankful we have medicaid to back our primary insurance up here in TX because it was ridiculous dealing with all of it before. I am sorry you are subjected to this. UGH! We use a company in Arlingon called ALLUMED, I deal with Ed. Maybe you could drive in and pick one up once it's here? Just so sorry!!!

  16. I absolutely agree with the others, do NOT order a chair from this company if they are already giving you the runaround. Keep in mind that they will have to be able to provide adjustments and "grow" the chair as your child grows (if that's the kind of chair you're getting).

    It does take a long time to get a chair, but I think four months is pretty ridiculous just to give you the info about pre-approval.

    As far as the price tag, we were told that the total price of the chair can be very dependent on the seat. Will your child be ok with an "off the shelf" type of seat, or need a custom one? This needs to be determined by experts (our medical supply company sent out their own representative who is a pediatric rehab specialist and can evaluate the child's needs while knowing what is available on the market) and met with our private physical therapist and one of the techs from the hospital/clinic who makes custom seats. They will weigh needs and limitations in all the options. But if you have to go with a custom seat, it can raise the price significantly. Like, thousands of dollars, significantly.

    I think the total cost to insurance for my Peyton's chair was around $6000, and that was for a manual chair with growth potential and a semi-custom seat.

    Our insurance also does not do pre-approvals, but the medical supply company has specialists who deal with the insurance companies enough that they pretty much know what will or will not be covered. I think they just made us pay for those items up-front and we paid our durable medical equipment co-pay (20%) when we got the chair.

    Also, I had them go over the cost of each component with me when the chair was ordered, so I could decide if something that would not be covered by insurance was worth paying for. That is your right, and I would encourage you to do that as well. Good luck!

  17. I'm thinking ditch this rep that came out to your house (it's his job and not your problem) and see what other options you have. I'd even do like you said and look into buying your own wheelchair online, especially if it turns out you'll have to spend that much money up front anyways. 4 months to get back to you on this? Really?

  18. A few words from the wise ... says:

    I think I would call the insurance and verify that "no pre-approval" policy. I really have a hard time believing that. I would also find out if you are restricted in your DME provider. If you can use any company, then shop around. I used Southern Medical Mart in Metairie and they were great. I don't know if they are still around after Katriba but check them out.

  19. I am so glad you have so much support and other parents to give you advice who have gone through this themselves. Thank you, ladies for helping out my friend. I say ditch the company. I want what is best for Charlie and you!

  20. Jailen's Mom :) says:

    Katy, I live in Louisiana too, on the Northshore. I got Jailen's chair from National Seating & Mobility out of Gulfport, Ms, but we did it through Children's hospital in New Orleans. Just to let you know, Jailen's chair is a tilt & it has the big push it yourself wheels on the back. It took him some time to figure it out because they aren't really supposed to go on this chair & are a little difficult to reach, but you CAN make it happen. Jailen is 4 & has had his chair for a little over a year now. He IS able to maneuver it on his own. You have to demand what you know your child needs & under no circumstances do you let someone tell you that you can't do something that way. You know your child best, you know what he needs. I wish you luck & if you'd like to talk you are more than welcome to email me & I'd even give you my cell. Take care of that beautiful baby, honey!! :)

  21. Get a new equipment company, and just decide from day one to call them often to check on the status. We are dealing with a new guy this time around and I can already tell he is so much better than the company we normally use. Why we didn't change sooner, Lord only knows.

  22. Oh, and this new guy says padded seats (what Clayton currently has) aren't necessarily the way to go. I would definitely research what is best for Charlie.