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Common Industry Myths
Myth: Scooters and power chairs are the same thing.
Fact: The general observer often uses the term "scooter" and power wheelchairs synonymously. However, these products have unique technological differences for in home use; primarily turning radius, medical necessity and safety. Read more…
Myth: Too many seniors use the power mobility benefit through Medicare.
Fact: Seniors who actually utilized this important benefit (complex rehabilitative, standard power wheelchairs or scooters) prescribed by their physicians were under the number predicted by Medicare from 2006 to 2008. In fact, on average only one in 200 people utilized this benefit. Read more…
Myth: Providers send seniors to doctors they know will prescribe power mobility.
Fact: Congressional law and Medicare regulations require a patient see their own treating physician for consideration for a power wheelchair. Their medical evaluation is the primary factor when considering whether medical need exists. Prior to the office visit, the patient is subject to our very thorough screening process. It is during this initial screening process that the company disallows 70% of those inquiring about power mobility from insurance consideration.
Those with medical conditions such as heart disease, lung disease, diabetes and MS (for example) are sent to their own treating physician for further evaluations. The physician will complete a comprehensive examination of the patient; not everyone will qualify. In fact, physicians generally rule out two out of every three patients they see.
Once a physician provides his prescription and complete medical records to The SCOOTER Store, a team of nurses with 520 years of clinical experience review the medical information to ensure medical necessity has been established by the beneficiary's physician. We have over 70 Quality Review Standards in place. In the end, only one out of every 11 beneficiaries qualifies for insurance-covered power mobility.
Myth: Marketing increases actual utilization of the power mobility benefit.
Fact: Education campaigns are designed to inform the general public about the advancements in power mobility technology and provide an alternative solution to costly nursing homes and institutional settings. In fact, marketing plays a minimal role in the final decision process for seniors, people with disabilities, their families and even their physician. Insurance companies, including Medicare require the patient to go see their own treating physician for consideration for power mobility. Many times, physicians want their patient to remain active so they provide other safe exercise or mobility alternatives.
Homecare providers also maintain strict compliance programs that are designed to ensure that only those who truly have a medical need receive the necessary care to carry out their activities of daily living. For example, at The SCOOTER Store, only one in every 10 seniors who believe they need mobility assistance receives a power wheelchair or scooter. Almost 78% of potential customers are disqualified by the company's initial extensive screening process. This screening process is made up of over 70 Quality Review Standards that include file reviews and file and phone audits to ensure medical necessity has been established by a beneficiary's physician. Additionally, all physician prescriptions and medical records are carefully reviewed by a highly qualified team of 60 nurses. Read more…
Myth: People who receive power mobility pass away within months of getting their chairs.
Fact: The average Medicare-covered power mobility recipient is 71 years old with an average of three chronic diseases states such as Chronic Obstructive Pulmonary Disease (COPD), diabetes, arthritis, and heart disease. According to industry data, nearly 92% of seniors who use power mobility to care for themselves live lengthy lives. Read more…
Myth: Power mobility providers cost Medicare money.
Fact: Providers actually save Medicare money through less hospitalization and emergency room visits due to falls and fall-related injuries:
- Hip fractures from falls account for 300,000 hospitalizations each year.
- Direct care for these injuries have been estimated to result in up to $18 billion in medical costs each year ($81,000 avg. for hip fractures alone).
Read more…
Myth: Most providers are just trying to make money.
Fact: Unfortunately, there are cases of Medicare fraud across the country where some beneficiaries were promised free power wheelchairs, and many either received nothing or a lesser valued product. Medicare and AAHomecare each have plans and programs to prevent fraud and abuse within the power mobility industry. Read more…
Myth: Most of the U.S. healthcare dollar is spent on power mobility.
Fact: In 2007, the United States spent over $2.1 trillion on health care, while the Medicare program spent just over $431 billion on it during the same period. The power mobility benefit accounted for 0.004% (or $865 million) of the total U.S. health care dollar. Under the Medicare program, the power mobility benefit accounted for 0.02% (or $865 million) of the overall budget. Read more…
