Preparing for Your Loved One’s Doctor Appointment

Edited

When preparing to discuss your loved one's need for a Cubby Bed with their doctor, it's important to focus on two key elements: safety concerns and medical necessity. By having clear, documented concerns, you’ll help ensure that your doctor has all the necessary details to support your request for both a prescription and a letter of medical necessity (LMN).

1. Preparing a Journal or Documentation of Concerns

In the days leading up to your appointment, consider keeping a journal of your concerns and documenting specific instances that highlight your loved one's need for the Cubby Bed. This information can provide a powerful narrative for your doctor and strengthen the case for insurance approval.

Some areas to document include:

  • Frequency of Occurrences: Keep track of how often safety-related incidents occur, such as wandering, falls, or seizure activity.

  • Injuries or Hospital Visits: If there have been injuries or hospitalizations resulting from nighttime incidents, note the dates and details of these events.

  • Specific Behaviors: Write down specific behaviors that happen at night and describe how these contribute to safety risks.

2. Documenting Attempts with Less Costly Alternatives

Be prepared to discuss any alternative solutions you’ve tried and explain why they were not successful. Insurance providers often require evidence that less expensive options were attempted before approving more specialized equipment.

Examples of alternatives you might have tried include:

  • Traditional safety gates

  • A less costly safety bed

  • Medication

Share why these methods were ineffective, such as your loved one's ability to bypass these solutions or how they did not sufficiently address the safety concerns.

3. Discussing Safety Concerns with Your Doctor

Begin by explaining in detail the specific safety concerns you have about your child’s current sleeping environment. This conversation is crucial because your doctor will need a clear understanding of why a safety bed is necessary.

Key points to cover:

  • Nighttime Risks: Describe any potential risks your loved one faces while sleeping or during nighttime, such as elopement, self-injury, or fall risk.

  • Medical Conditions: If applicable, mention medical conditions and any diagnosis like seizures, autism, or other conditions that heighten the need for a safer sleep space.

  • Specific Behaviors: Provide examples of behaviors that could result in harm, such as climbing or getting out of bed unsupervised.

The more specific and detailed you are in this conversation, the easier it will be for the doctor to understand the need for the Cubby Bed.

4. Importance of a Detailed Letter of Medical Necessity

The letter of medical necessity will need to reflect the concerns and examples discussed during your appointment. The doctor will include this information when writing the LMN, which will be sent to your insurance provider as part of the claim for the Cubby Bed. The LMN can also be written by an occupational therapist (OT) or physical therapist (PT).

Providing your doctor/OT/PT with as much detailed information as possible will help ensure the letter clearly explains the medical need for the bed and why it is essential for your loved one's safety.