The discharge planner gives you the name of a medical equipment supplier. A walker, wheelchair, hospital bed or commode may already be ordered.
Before you say yes, get the exact item in writing. Then compare the supplier on six things: insurance, availability, delivery, teaching, service and returns.
You are not choosing the best company in St. Louis. You are checking whether one company can provide the right item, under the right coverage rules, before your parent needs it.
Day 0, still in the bed: identify the exact order
Ask the discharge planner to write down the generic name of each item. Ask whether the order includes accessories, size, weight capacity or other required features. A note that says only “walker” or “wheelchair” may not tell a supplier enough.
Ask who decided on the item and whether a therapist watched your parent use the same type of equipment. Do not let a supplier's delivery promise substitute for a hospital assessment of what your parent can use. MedlinePlus advises matching mobility aids to the person's needs and learning how to use them safely. The hospital's discharge process must also address the patient's goals and include the patient or caregiver in planning. (MedlinePlus, Mobility Aids; CMS, Requirements for Hospital Discharges to Post-Acute Care Providers; 42 CFR 482.43.)
If the hospital has sent the order already, ask for the supplier's name and phone number. Ask whether that company was selected because of your parent's insurance network, because it had the item available or simply because it commonly receives hospital referrals.
You can ask about another supplier. The practical limit is time. A different company still needs the order, supporting records, coverage approval when required and a way to deliver the correct item.
Call the insurance plan before comparing promises
If your parent has Original Medicare, confirm that the supplier is enrolled in Medicare. Then ask the supplier a separate question: “Will you accept assignment for this item and for every rental month?” Enrollment and assignment are not the same thing. A participating Medicare supplier must accept assignment. A nonparticipating supplier may accept it for a particular claim, but does not have to. (Medicare, Durable Medical Equipment Coverage; Medicare, Does Your Provider Accept Medicare as Full Payment?)
If your parent has Medicare Advantage, call the plan. Ask which suppliers are in network for the exact item. Ask whether prior authorization is required and whether the hospital has sent the records the plan needs. Do not rely only on a supplier saying it “takes Medicare.”
Ask whether the item will be rented, purchased or handled under another payment category. Medicare treats different equipment differently. Some equipment is rented. Some is purchased. Some may offer a choice. (Medicare, Durable Medical Equipment Coverage; 42 CFR 414.220 and 414.229.)
Write down the name of the plan representative, the supplier and the answer. You need a short record if the hospital, plan and supplier later give you different instructions.
Compare two suppliers with the same six questions
First, do you have the exact ordered item? Read the description from the order. Ask the supplier to repeat what it will deliver. If the model or features differ, ask the hospital clinician whether the substitute still meets the order.
Second, when and where will it arrive? Get a delivery window. Ask whether someone must sign. For a hospital bed or other large item, ask who clears space, assembles it and removes packaging. “Available” is not the same as “installed before arrival home.”
Third, who teaches us to use it? Ask whether the person delivering it will demonstrate adjustments, brakes, folding, charging, cleaning and safe storage, as applicable. Medicare supplier standards require delivery records and necessary instructions for safe and effective use. (42 CFR 424.57(c)(12).)
Fourth, what happens after hours? Ask which number reaches service, what counts as an urgent equipment problem and how replacement equipment is handled. For rented Medicare-covered equipment, the supplier must maintain, repair or replace it so it functions as intended. (42 CFR 424.57(c)(14); Medicare, Medicare Coverage of Durable Medical Equipment and Other Devices.)
Fifth, what can be returned? Ask what happens if the item is the wrong size, unsuitable when fitted or not in full working condition. Medicare supplier standards require acceptance of certain substandard or unsuitable items. Ask the supplier to explain its process before delivery. (42 CFR 424.57(c)(15).)
Sixth, what will we receive in writing? Ask for the order description, rental or purchase status, assignment answer, expected patient responsibility, warranty information, service number and return instructions. Medicare-enrolled suppliers must disclose their supplier standards, answer questions and maintain a complaint process. They must also honor applicable warranties without charging for repairs or replacements covered by the warranty. (42 CFR 424.57(c)(6), (13), (16), (19) and (20).)
A polished phone call is not the deciding factor. Prefer the supplier whose answers match the written order and the insurance plan, and whose delivery and service duties are clear.
Day 1, the car pulls in: check before your parent uses it
Match the delivery slip to the written order. Check the item name, size, accessories and condition. Photograph the label and delivery paperwork. Save the supplier's service number in your phone.
Have the delivery person demonstrate the equipment. Then have your parent or the person helping them repeat the basic steps, if that can be done safely. If the item looks different from the hospital equipment, stop and call the hospital contact or ordering clinician before improvising.
Do not sign a statement saying teaching was completed if no one showed you how the item works. Note missing parts or visible damage on the delivery record.
Day 2 to Day 3, the first full days: test the service, not your parent
Watch for practical mismatches. Does the walker fit through the needed doorway? Can the wheelchair reach the bathroom? Can the caregiver operate the brakes and footrests? Is the service label readable?
If something does not fit or function, call the supplier. Use plain words: “The delivered item does not match the order,” “The brake does not hold,” or “This item was unsuitable when fitted.” Ask for a complaint or service reference number.
Also call the ordering clinician when the problem concerns what equipment your parent needs. The supplier handles the item. The clinician handles the medical order.
Day 3 to Day 7, the week: close the paperwork gaps
Look for the Medicare Summary Notice or plan explanation when it becomes available. Match the supplier name and item to what was delivered. Keep rental agreements, delivery records and warranty papers together.
If a rented item needs repair, start with the supplier and document each call. If a Medicare supplier does not respond, Medicare directs beneficiaries to contact Medicare for help. (Medicare, Medicare Coverage of Durable Medical Equipment and Other Devices; CMS, Competitive Acquisition Ombudsman beneficiary guidance.)
If a hospital discharge problem involved missing equipment information or an incomplete referral, contact the hospital's patient relations or care management office. CMS requires hospitals to transfer necessary medical information to the suppliers responsible for follow-up care. (CMS, Requirements for Hospital Discharges to Post-Acute Care Providers; 42 CFR 482.43.)
Missouri's Department of Health and Senior Services receives complaints about the home health agencies and hospice programs it regulates. Equipment supplier complaints follow different routes, including the supplier's required complaint process, the insurance plan and Medicare when Medicare coverage is involved. Do not send the complaint to the first agency name you find. Ask which entity regulates the service you actually received. (Missouri Department of Health and Senior Services, Home Care; 42 CFR 424.57(c)(19) and (20).)
Your final check is short. The item matches the order. Coverage is confirmed. Someone showed you how it works. You know who repairs it. You have the return rules and paperwork.
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