Insurance Coverage and Funding for Kayser Betten US Beds
At Kayser Betten US, we understand the importance of providing safe, secure sleeping solutions for individuals with medical and special needs. Many of our specialty safety beds may qualify for coverage through Medicaid, private insurance, and other funding sources.
While Kayser Betten US does not bill insurance directly, we work closely with families, caregivers, and Durable Medical Equipment (DME) providers, who are qualified to recommend and supply the appropriate bed model based on the individual’s medical needs.
This guide outlines the general process for securing insurance coverage for a Kayser Betten US bed. Please note that each state has its own regulations and program requirements, so individual cases may vary.
STEPS TO OBTAIN INSURANCE COVERAGE
To request insurance coverage for a specialty safety bed, two key documents are typically required:
1. A Letter of Medical Necessity
2. A Prescription from a Physician
Creating a Strong Letter of Medical Necessity
The Letter of Medical Necessity (LMN) should clearly explain the patient’s specific medical and safety needs and why a traditional bed or hospital bed is not appropriate. The letter must justify the need for specific features such as higher safety rails, adjustable foundations, or padding.
Suggested Outline for a Letter of Medical Necessity:
1. Patient Introduction:
State the patient’s name, diagnosis, and duration under the doctor’s care. Detail medical and safety concerns such as:
- Seizures
- Physical or cognitive disabilities
- Fall risks or lack of awareness of danger
- Prior injuries from existing beds or side rails
- Risk of entrapment or suffocation in standard beds
2. Current Bed Limitations:
Describe how the current bed or sleeping environment fails to safely accommodate the patient, including potential hazards like climbing, entrapment, or falls.
3. Clinical and Emotional Benefits:
Explain the need for a medically safe environment that allows for regular care, monitoring, and emotional security for the patient and their caregivers.
4. Recommended Bed Model:
Specify the exact Kayser Betten US bed model and foundation type needed to address the medical concerns. Be precise with required safety rail heights, articulating foundations (head, knee, or full Hi-Lo adjustability), and other safety features.
5. Consistency Between Documents:
Ensure that both the LMN and the physician’s prescription reference the same exact bed model and configuration to prevent insurance claim delays or denials.
What to Do if a Claim is Denied
If your insurance claim is denied, you typically have the right to appeal. Pay close attention to deadlines, as appeals often must be filed within 15 to 30 days.
Resources for Appeals:
1. State Legal Aid Services: Find legal assistance programs in your state via this link. Services are often free for qualifying individuals.
2. Patient Advocacy: Many DME providers can assist when contacting advocates. A HIPAA release form may be needed to allow them to speak on your behalf.
Important: Be prepared before seeking help. Gather a comprehensive information packet that includes:
- Patient details
- DME provider and Kayser Betten US contact information
- Denial letters
- Letters of Medical Necessity
- Cost analysis showing alternatives considered and why your requested bed is medically necessary and cost-effective
- Exact product details and brochures for the recommended Kayser Betten US bed
Why Specialty Safety Beds Are Medically Necessary
Kayser Betten US beds are designed for individuals with complex medical needs where a traditional or hospital bed poses safety risks. Our beds help:
- Prevent falls and climbing
- Reduce the risk of entrapment and injury
- Provide a secure, padded environment
- Support proper positioning with adjustable foundations
Beds with varying safety rail heights and articulating or Hi-Lo foundations are available, and choosing the right configuration is crucial for each unique medical case.
For additional safety information, you can refer to resources such as the FDA’s Hospital Bed System Dimensional and Assessment Guidance to Reduce Entrapment.
Helpful Resources
For families navigating insurance denials or appeals, these resources offer practical advice:
Complex Child E-Magazine:
WE’RE HERE TO HELP
Our team at Kayser Betten US is committed to supporting families and providers through the insurance process. If you have questions or need assistance selecting the right bed for your patient’s needs, please contact us.
