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Can SleepSafe Beds Be Covered Below is a summary of our experience in dealing with requests for insurance and/or Medicaid financial assistance. Two basic requirements are necessary: About Letters of Necessity: In a letter of medical necessity, it must be clear that a SleepSafe bed addresses SPECIAL NEEDS. The key is to emphasize the clinical needs of the patient. It must be pointed out how his or her needs are not being met by the bed they are currently using. Once the failings or dangers of the current bed have been detailed, a SleepSafe product can be prescribed in answer to the particular needs. We also believe it is important not to lead with a mention of a SleepSafe product, but rather wait until the 4th phase in the outline below. A Basic Outline for a Letter of Necessity 1. Introduce the patient and how long she or he has been in the care of the doctor or facility. Describe his or her condition and detail the special needs that are a consequence of the condition (i.e. lack of control; no recognition of danger in rolling or falling out of bed; entanglement in side rails if a "hospital/institutional" bed is currently in use and the potential or documented injury as a result; potential of entrapment or suffocation due to the gaps around the mattress on either side or at the ends—especially the corners.) 2. Explain how the bed or crib currently being used fails to protect the patient and the consequence of falling will result in bodily harm. Include, if applicable, how the patient has the capacity to climb. 3. Perhaps address the psychological issues regarding the importance to see out and be seen/acknowledged, and/or not be trapped in a bed with an enclosure over the top. 4. Recommend the bed model that addresses each of the concerns—with specific requirements such as full safety rails, or specific height required for safety (where the double safety rail and mattress height adjustability of the SleepSafeR model would accommodated the needs), or the necessity of articulation to raise the head or feet of the patient in order to feed, medicate, or provide mobility. 5. The imperative that the specific needs be addressed, and prescribe the appropriate model (SleepSafe, SleepSafePlus, SleepSafeR, or SleepSafeRPlus). About Medicaid - Use code Miscellaneous Code #1399 One hurdle we are encountering is the issue of how a SleepSafe bed model is classified under Medicaid/Medicare codes (HccPc is their acronym). At issue here may be that they may try to classify our beds as a hospital bed or crib, either of which brings in a host of regulatory issues including a base price allowance. While this may be appropriate for a generic case, it must be understood that SleepSafe bed models do not conform to those codes because the beds are safety beds to address people with special needs. As such, our bed need to go through the prior approval process. Our understanding is that miscellaneous code #1399 should be used because a SleepSafe product can be defined within it. We appreciate the opportunity to work with you and help find a way to work through the process. Please feel free to email us if we can be of further assistance.
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