Medicare Semi Electric Hospital Bed

Medicare can help a person get the medical equipment they need at no or little cost to them.  A person does not have to stay in pain because they cannot afford to purchase the needed medical equipment. A Medicare semi electric hospital bed can help a person with limited mobility at no or little cost to them.Medicare Semi Electric Hospital Bed

Functions of a Medicare Semi Electric Hospital Bed

A person that is covered by Medicare Part B can get a semi electric hospital bed if their health requires it. This medicare semi electric hospital bed will allow the user to adjust the head and the foot sections to make it more comfortable and to increase blood circulation. All they need to do is push a button in order for the bed to adjust. However, a crank is sometimes still needed to adjust the height of the bed but a person will be able to adjust their head and feet with the touch of a button. A doctor will need to recommend the specific bed for their patient and if the patient is on Medicare they can get it at no or little cost to them from a Medicare Approved Supplier like Towson Medical Equipment.

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Medicare Semi Electric Hospital Bed Instructions

Take these forms to your doctor:   Semi Electric Hospital Bed Order Form

 

Included in this package:

  • A semi electric frame (head, feet = electric)
  • Bed rails (half length or full length)
  • Mattress

 

 

If the patient has MEDICARE only (Part B):

Please note that this is a rental for 13 months

Please expect a co-pay of $15.75

 

 

Included in the Required Paperwork Packet:

  • A detailed written order
  • A face to face form
  • A list of what Medicare requires be addressed in chart notes

 

 

*All paperwork must be completed by same provider.

 

*Provider must be PECOS certified

 

PATIENT:                                DOB:

ADDRESS:      

PHONE: (   )    –                    SOCIAL SECURITY #:  xx

 

 

EFFECTIVE DATE:           7/16/15       

ICD-10 DIAGNOSIS CODES: _____________________________________________

ICD-9 DIAGNOSIS CODES:                                                                                             

DESCRIPTION OF ITEM:             ELECTRIC HOSPITAL BED                                   

LENGTH OF NEED:           99        (99 = lifetime)

 

I, the undersigned, certify that the above prescribed items are medically necessary as part of my treatment plan for this patient and have not been prescribed as a convenience.

 

PHYSICIAN:      

ADDRESS:      

PHONE: (   )    –                       FAX: (   )    –

NPI #:

 

 

SIGNATURE:                                                                   ___    DATE:                             

FACE TO FACE FORM

PATIENT:                                                                                           DOB:      

ADDRESS:      

CITY, STATE, ZIP:      ,

PHONE: (   )    –                    SOCIAL SECURITY #: xx

 

EFFECTIVE DATE:                                                 

ICD-10 DIAGNOSIS CODES: ________________________________________

ICD-9 DIAGNOSIS CODES:                                                                                             

DATE OF FACE-TO-FACE EXAMINATION: ___                                                        

DESCRIPTION OF ITEM:                                                                                                                                                                                                                                     

LENGTH OF NEED:                         (99 = lifetime)

 

I, the undersigned, certify that the above prescribed items are medically necessary as part of my treatment plan for this patient and have not been prescribed as a convenience.

PHYSICIAN:      

ADDRESS:      

CITY, STATE, ZIP:      ,

PHONE: (   )    –                                FAX: (   )    –

NPI #:

 

SIGNATURE:                                                                   ___    DATE:                            

 

INSURANCE REQUIRED DOCMENTATION

 

PLEASE PROVIDE CHART NOTES (NOT THIS SHEET) THAT ADDRESS ALL OF THE FOLLOWING THAT APPLY:

 

  1. The patient has a medical condition which requires positioning of the body in ways not feasible with an ordinary bed.  Note:  Elevation of the head/upper body less than 30 degrees does not usually require the use of a hospital bed. OR
  2. The patient requires positioning of the bed in ways not feasible with an ordinary bed in order to alleviate pain.  OR
  3. The patient requires the head of the bed to be elevated more than 30 degrees most of the time due to congestive heart failure, chronic pulmonary disease, or problems with aspiration, OR
  4. The patient requires traction equipment, which can only be attached to a hospital bed.

AND

  1. The patient requires frequent changes in body position and/or has an immediate need for a change in body position