Standing: The Funding Challenges

The act of standing is as old as humankind. But as a beneficial positioning regimen, standing is still a relatively new concept to many funding sources. As a result, the obligation is on clinicians and providers to provide documentation that medically justifies the standing device and explains the complex rehab team’s goals.

Nancy Perlich, COTA, ATP, works in reimbursement, education and product development for Altimate Medical. While every seating & mobility client presents differently and has different goals and clinical needs, Perlich gives the following suggestions about what information a clinician or provider should typically include when justifying a standing device to a payor.

Detail the consumer, medically and functionally.

Include client name, date of birth, diagnosis, onset, height, weight, primary funding.

  • Describe the consumer’s level of function (i.e., ambulation, transfers, ADLs, living environment, etc.).
  • Describe medical issues that will be affected by the standing technology and the outcomes expected (i.e., abnormal muscle tone and reflexes, range of motion, systemic functions, loss of bone density, etc).

Explain how the standing device will help achieve goals/outcomes.

  • What other less costly alternatives were considered (i.e., range of motion, splints, other methods of weight bearing)?

Describe the assessment.

  • Document the types of standing devices that were considered and rejected.
  • Document the devices that were trialed and why each trial was either approved or rejected.

Describe your recommendations for the standing device.

  • What type of standing device is being recommended and why?
  • What options/accessories are being recommended and why (i.e., lateral thoracic supports to assist with symmetrical alignment of the upper body, etc.)?
  • What is the prescribed standing program (i.e., minutes/hours per day, days per week)?
  • Include the date and both the therapist’s and doctor’s signatures.
  • Include supporting material and media (i.e. clinical studies/research, video, etc.).

This article originally appeared in the June 2012 issue of Mobility Management.

In Support of Upper-Extremity Positioning