Abstract
Objectives Power mobility devices (PMDs) such as power wheelchairs and scooters are crucial
for mobility, self-care, employment, and leisure activities. The documentation process
for insurance coverage is complex and requires communication and document delivery
among multiple stakeholders. The objective of this project was to develop an electronic
submission process for medical documentation of PMDs submitted for prior authorization
to a Medicare Administrative Contractor (MAC) and implement a standardized means of
communication between providers and payers.
Methods A protocol was developed to create and securely transmit an electronic prescription
and several documents that outline medical necessity from a clinical team using EpicCare
to a MAC via a Health Information Handler. A Rehabilitation Technology Supplier (RTS)
added detailed product information and specifications to the electronic package during
transmission.
Setting The setting involved in the study was University-based outpatient assistive technology
clinic.
Results The protocol demonstrated successful transmission of an order, medical documentation,
and request for signature. Results were transcribed to a readable format for the clinical
team and RTS. A set of quality metrics for use in future projects was also identified.
Conclusion This pilot project demonstrated successful electronic exchange and transmission of
medical documentation for durable medical equipment from the electronic health record
to a MAC.
Keywords
electronic health records - interoperability - medical documentation - rehabilitation
- wheelchairs
