Ordering wheelchairs – AADL process

When choosing wheelchair features with AADL clients, vendors need to be aware of some processes affecting the choices and costs involved.

1. Calculating client costs

When calculating costs, advise your clients that the amount you calculated is an estimate, and that AADL confirms all calculations are correct. If there is a significant difference, AADL will advise the authorizer.

2. Authorizer must calculate upgrade costs

The client has to sign the authorization form confirming they are aware of any upgrade costs. The only way the authorizer can advise the client of upgrade costs is to do the calculations. The revised standardized spec sheets have a simplified calculation table.

Vendor discounts have already been calculated and included in all the prices on these standardized spec sheets so you do not need to consider the vendor discount.

3. Considerations when requesting wheelchair options not on the spec sheets

Category A adult wheelchairs are intended for basic use, and must be easily recycled; they are the most recycled wheelchair type in the program (approximately 80%). Allowing clients to add other options can result in increased costs to the program. Recycle wheelchairs have to be reconfigured for the next person.

If an option has been added, such as adding spoke tires, it might have to changed back to the standard option after its return, and this is an additional expense to the AADL program. The standard option will also reduce maintenance expenses for the client.

4. Tables on the standardized spec sheets on manufacturer’s website

The manufacturer spec sheets on the AADL website do not include additional tables. If you need the complete tables with the spec sheets, they are available on each manufacture’s website. The manufacturer, as product expert, will reference the tables when consulting on configuration requirements.

When the therapist determines the base measurements, such as seat and back width, depth and seat to floor height, the manufacturer will assist in determining which components are required to configure the wheelchair to your client’s needs.

5. Price discrepancies between spec sheets and parts lists

There might be a discrepancy between the parts price lists and spec sheets. The price list is used when replacing a part or repairing a wheelchair. The standardized wheelchair spec sheet is used for new purchases. Prices on the standardized wheelchair spec sheet are rounded up to keep calculations simple.

When authorizers submit an authorization form, use the standardized spec sheet prices. If the wheelchair comes from recycle, the benefit clerks and manufacturer will determine which parts need to be replaced and will use the parts price list.

6. Eligibility for a Category B wheelchair

If a client is independent indoors but dependent outdoors, they would not be eligible for a Category B wheelchair. The client must be fully independent both indoors and outdoors to be eligible for a Category B or higher.

Category B wheelchairs cannot be order solely because the wheelchair needs to be transported. Wheelchairs in Category A also have quick release axles; these should be ordered for client’s who need to pack their wheelchair in a vehicle. Wheels and footrests can be removed to make the wheelchair lighter for lifting into vehicles.

Another option is to authorize a Category A grant of $2000. The client may then choose any wheelchair on the program as long as they understand they are responsible for all maintenance costs and cannot apply for another wheelchair grant for 6 years.

7. Pediatric wheelchairs

The Category A, B, D grants are not available for pediatrics, since a child will typically grow and change before the six-year period expires.

8. Power wheelchair upgrades and higher category manual wheelchairs

Wheelchair grants for higher category wheelchairs are provided according to the client’s eligibility. If the client is eligible for a Category A and wants a higher category, they will still receive a Category A grant. Therefore, the grant will not be an indication the client meets the higher abilities required to access the higher category. As long as the client meets the eligibility criteria for power, it will not interfere.

9. Check off all required spec sheets options

In most cases, if spec sheets options are not checked off, they will be omitted. For example if you do not check off the seatbelt or grade aid under other options, they will be omitted.

  • If you miss an option that is integral to the wheelchair such as casters, the form will not be processed.

Ensure you check off all items that are necessary for the wheelchair to function. Vendors will be responsible to ensure the spec sheets submitted to the manufacturer are complete and include all components necessary to configure the wheelchair as ordered.

10. Adding additional W codes

If you need additional W codes, such as the adjustable tension back upholstery and the one-arm drive, write the W codes under Section 5: Clinical Information on the 1251 form. NOTE: Section 7 is restricted to AADL use only.

11. Adding adjustable tension backs (W108 or W109-TBU)

If you need to add adjustable tension backs (W108 or W109-TBU) to the standardized spec sheets, be aware of these requirements:

  • #5 refers to the back canes when applying the adjustable tension back upholstery
  • #6 is selected to omit upholstery, and also check off the W code under other options. You can indicate the back height under #6 but write in “BTU” next to BACK HEIGHT.

12. Ordering a generic component

The standardized spec sheets indicate if the component is generic or manufacturer in brackets. AADL will use the most cost effective component.

  • On the Catalyst 4, generic BTU’s are ordered (the manufacturer specs have different replacement parts making the pricing complex).

When AADL orders a new wheelchair, it will not order integral generic component parts as this makes setting up the wheelchair more complex. For example, if generic wheels cost less than the manufacturer’s, AADL does not expect you to order generic wheels separate from the main frame and other components. Specific generic pricing is listed under the other options at the end of the standardized spec sheets rather than manufacturer pricing.