• Schedule an appointment with your loved one’s doctor.
• Before your visit, print the Prescription Form in the Required Documents Packet. If you do not have access to a printer, ask the provider to print it for you at the appointment.
• Discuss the medical need for a Cubby Bed during your visit and ask the doctor to fill out the printed Prescription Form. 
• Locate a Medical Supplier that carries Cubby Beds and accepts your insurance. The supplier will help guide you through the insurance process and assist in gathering the required documents. They will also need to be present during an evaluation performed by an OT or PT in order to receive a Letter of Medical Necessity (outlined in the next step).
• Obtain a Letter of Medical Necessity (LMN) from an Occupational Therapist (OT) or Physical Therapist (PT). An LMN written by a physician will NOT be accepted. If you do not have access to an OT or PT, consult with your chosen Medical Supplier. Use our Safety Needs and Concerns Worksheet to write down your loved one’s safety concerns and any other solutions you’ve tried that didn’t work. The level of detail you provide is crucial to ensure your medical documents fully capture your loved one's need for a Cubby Bed. The Medical Supplier will need to be present at the evaluation by the OT or PT, so make sure you are connected with a supplier before requesting the LMN.
• The details discussed on the Safety Needs and Concerns Worksheet should be documented in your loved one's medical record. If the information is not in their record, request that the doctor add it to the chart notes. 
• Follow up with the medical supplier: Confirm they’ve received all the necessary documents and ensure they’ve submitted your request to Medicaid.
  
  

For more information on how to get a Cubby Bed, visit our website.

• Complete the Prescription Form, which is included in the Required Documents Packet. 
• Medical necessity and safety concerns should be clearly documented in the patient’s chart.
• Explain the significance of a Letter of Medical Necessity (LMN) to the patient, so they have a plan to obtain one. Georgia Medicaid requires the letter to be written by an OT or PT, and will NOT be accepted by a physician.
• Once your patient has partnered with a medical supplier, please send the Prescription Form directly to the supplier. You may need to work with the supplier to provide revisions or additional paperwork that insurance requests for the authorization process or for appealing a denial.

• Work with the family to write a Letter of Medical Necessity (LMN). Use the guidance provided in the Required Documents Packet for the details that need to be included. Ask the family to share their completed Safety Needs and Concerns Worksheet with you, which will help you write a detailed letter. In addition to the recommended guidance in the above packet, be sure to address the following:
  → Patients with severe behavioral disorders need to have a documented plan for behavioral management.
  → Where is the member currently sleeping and why is it no longer working?
  → What are the specific features of the requested safe bed that are medically necessary for this member?
  → Provide your written plan for monitoring the member that has been approved by the ordering physician describing when the bed will be used, how the member will be monitored, how all the member’s needs will be met while enclosed in the bed (toileting, eating, hydration, skin care and general safety), and an explanation of how any documented medical conditions (e.g., seizures) will be managed while the bed is in use.
  → Must provide safety, cognitive, behavioral and boundary concerns. Evaluation should specify the need for a safe bed, including how the requested bed was chosen over other options.
  → Any requests for a built-in technology hub, or any other specific features or components, should include specific documentation on the need for the features. 
• Once your patient has partnered with a medical supplier, please send the LMN directly to that supplier. You may need to work with the supplier to provide revisions or additional paperwork that insurance requests for the authorization process or for appealing a denial.

• Georgia requires the Certification of Medical Necessity for Custom Durable Medical Equipment form signed by the ordering physician, in addition to the OT/PT.
• An ATP will need to be present during the evaluation by the OT or PT.
• Communicate regularly with the family and providers to improve the chance of approval.