I haven’t made a post or been able to research in months do to no longer having an internet connection on my computer. I am writing this from my cell phone. I have an exciting post coming very soon though, so stay tuned.
Our mission is to enhance the lives of people with disabilities and their families through providing a cycling experience which will increase their self confidence and allow the entire family to participate.
We seek to promote family, independence and well-being for all who participate.
Well part two of “A Medical Necessity” has been a learning experience for me to say the least. I started out with very good intentions hoping to find an easy way for all of us parents to get some help with acquiring adaptive cycles or recumbent tricycles for our children and for our disabled veterans, what ever special needs they have. This endeavor is going to take a little longer than a night or two from the looks of it. All that I can promise is to compile as much information as possible that will be the most beneficial to everyone.
This is an excerpt from www.thefreelibrary.com along with a link to the complete article.
Typically, a piece of adaptive equipment is utilized to increase a child’s function. Examples of adaptive equipment or assistive technology are wheelchairs, lifts, standing frames, gait trainers,augmentative communication devices, bath chairs, and recreational items such as swings or tricycles. The process of obtaining a particular piece of equipment is defined primarily by the funding source. The funding source may be through your child’s health insurance; it may be through the child’s school system; or it could be through private funding.
While it is typically the duty of a medical professional to write a Letter of Medical Necessity, there are other people whose opinions can help sway those reviewing the claim. Teachers, case managers, counselors and parents all provide different points of view that are valid to establishing medical necessity. Their description of how the patient functions in various settings and how that can be improved with the desired intervention can not always be provided by a medical professional. While their views should not be submitted alone, they are an excellent complement to a medical opinion.
There is more information to come in the next installment of A medical necessity.
I have been doing some research recently on the positive effects that bicycling can have on children and adults with disabilities. Having watched videos on the subject, read articles and listened to remarks from therapist on Youtube, everything seems to point to one conclusion. Bicycle riding is therapeutic, both mentally and physically for children as well as adults. The problem is the cost. Most parents and adults wanting to get a recumbent tricycle or a bicycle that is made specifically for persons with disabilities can’t afford them. Carrying price tags ranging from two hundred eighty dollars for a basic tricycle to over five thousand dollars for a tandem cycle. If a doctor and/or therapist decides that a child or adult needs the bicycle and/or tricycle for physical and emotional therapy, and tells the insurance company that it is medically necessary to help the child/adult with their therapy, then the insurance company should pay for it. Right?
I began my search for the answer on About.com where MichelBihariM.D. writes “Health insurance companies provide coverage only for health-related services that they define or determine to be medically necessary.”
I have posted a link to the ABOUT.COM websiteMedical Necessity – Definition of Medical Necessity.
The link below is to the Free Online Medical Dictionary along with their definition of “medically necessary” and its criteria.
This is an article that I found in American Profile http://www.americanprofile.com on Hal Honeyman, founder of Creative Mobility, which builds modified-bicycles and the non-profit Project Mobility, which sponsors bike-fitting clinics and workshops nationwide.
This an excerpt from an article in the September – October 2007 edition
of Martha’s Vineyard Magazine. David Whitmon talks about ridding his bicycle built for three “Boooger”with his two daughters, Gaia who was fourteen at the time the article was written has Asperger Syndrome and Gracie who was twelve and is Autistic.