ProBed Medical Technologies Inc.
#602 - 30930 Wheel Ave.
Abbotsford, BC, Canada V2T 6G7
Tel: 604.852.3096 Fax: 604.852.3097
Toll Free: 1.800.816.8243 www.pro-bed.com

Letters of Medical Necessity - ProBed Freedom Bed

Guidelines for Writing a Letter of Medical Necessity to Support the Purchase of the Freedom Bed

A letter of medical necessity in many cases can be critical in having an insurance company, government agency, or other funding source reimburse the purchase of a Freedom Bed™ for you, your client, or your family member. In many cases funding agencies may opt for a substitute unless a strong case can be made for medical benefits of the Freedom Bed™.

We've found in the past that a successful letter / prescription from a health care professional has the following components:

  • A clear description of the patient's condition that is causing the immobility and which prevents them from physically turning themselves.
  • A description of the clinical problems that the patient has experienced, is experiencing, or could experience if something wasn't done to alleviate their situation. This would include such things as pressure ulcers, bladder and respiratory infections or severe sleep deprivation from being manually turned during the night to prevent pressure ulcer formation. It can also be very useful to describe any problems (such as a respiratory infection or pressure ulcer) that the person has experienced and which required more intensive hospital care. Try and describe what the medical condition was and how long it took to solve the condition. The key is to demonstrate that the product is Medically Necessary.
  • Describe the technology that you want to have funded and explain how you expect that technology to solve some or all of the clinical problems that you have described above.
  • Be very specific about the equipment you want. Provide catalog / model numbers, accessories required, vendor's contact information, etc. If you don't do this then you might find that the funding agency will try and substitute a  less expensive (and most-times inferior) product.
  • If you can provide any estimate of how use of the product will save money, directly or indirectly by preventing illness, diseases, turning labour etc. indicate these as well.

If the healthcare professional(s) covers these areas then the chance of success is very high. Having this from a variety of sources is also beneficial (such as a prescription from an M.D. and a good letter from a case manager, therapist, or social worker. Please contact ProBed if you need additional assistance in this regard.


Sample Letter of Medical Necessity (#1)

Following is a Sample Letter of Medical Necessity, an actual letter with names changed and other required products removed:

To Whom It May Concern:

Mr. Smith is a right-handed 36-year old male with a diagnosis of C6 motor and C4 sensory spinal cord injury. He is having problems with the ability to control essential electrical devices while in bed and has skin issues related to his inability to turn himself while in bed. We are requesting devices to provide increased independence with these problem areas.

On physical examination this patient presents with severe quadriplegia and right arm function that is limited to gross movements of pushing on objects with a closed hand with light force. He has experienced progressive weakness of his right wrist since October, 2001, and has no right wrist extension at this time. When sitting upright he is able to marginally and slowly (but effectively) operate an adapted remote control, a computer trackball, and selects single keys on the computer keyboard.

Mr. Smith works full-time and is quite active in his community. He lives in a single story accessible home and has 3 hours of paid caregiver assistance in the mornings only. He depends on a family member to help him to bed in the evening and then is unattended until morning. A cousin lives in a room at the opposite end of the house and is available on an occasional basis.

Mr. Smith reports significant erythema at both lateral hip areas that takes 3-4 hours to dissipate due to the inability to provide effective pressure relief. He currently has a bed overlay that is no longer sufficient to provide necessary skin protection without additional caregiver support.

Because of the above, we are recommending the following devices for this patient who is expected to function well for the long term. Mr. Smith has thoroughly reviewed these and alternate options. He is highly motivated for independence and has the technical skills to ensure the requested devices will be used to their intended potential. He has remained as independent as possible and we feel these appliances will assist him in maintaining adequate independence.

  1. The Freedom Bed™ (PAR3-A3F), a programmable, automatic, laterally rotating bed, This device is necessary to provide independent rotation at night while in bed to decrease hip and rib erythema, increase patient independence, and reduce caregiver needs. The unique capabilities of the Freedom Bed™ are not found in any other beds currently on the market.                          

Signed,  

and,



John Doe, MD

Bob Jones, Occupational Therapist


Sample Letter of Medical Necessity (#2)