• 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. 
• Obtain a Letter of Medical Necessity (LMN). It is highly recommended that it be written by an Occupational Therapist (OT) or Physical Therapist (PT). If you do not have access to an OT or PT, consult with your chosen Medical Supplier (see next step), or if necessary, a physician can write the LMN. 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. 
  → Medicaid policy states that enclosed bed systems are not covered when the purpose is to restrain the beneficiary due to behavioral conditions, caregiver need or convenience.
• Locate a Medical Supplier that carries Cubby Beds and accepts your insurance. 
• 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.
• If writing the LMN, since Michigan Medicaid’s policy states that enclosed bed systems are not covered when the purpose is to restrain the beneficiary due to behavioral conditions, caregiver need or convenience, the following must be shown:
  1. If applicable, documentation to substantiate the need for the bed should include:
  → Evidence that the patient is at risk of falls, has impaired motor skills, poor executive function, sensory outbursts, wandering, and/or elopement; or
  → If the patient is diagnosed with a motor and/or behavioral disorder that leads to a heightened risk of injury to themselves, others, and/or property and is at an increased risk of morbidity or mortality.
  2. Documentation must show the caregiver has tried solutions such as:
  → Side rails, placing the mattress on the floor, medications to address seizures or behaviors, behavior modification strategies, a helmet for headbanging, removing safety hazards from the member’s bedroom, etc.
  → Detail indicating why those other solutions did not address the patient’s sleep safety needs.
  3. Documentation should address if the patient would be at risk for injury, harm, or putting themselves or others in danger without the bed.
• Once your patient has partnered with a medical supplier, please send the document(s) 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.

• 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.
• Since Michigan Medicaid’s policy states that enclosed bed systems are not covered when the purpose is to restrain the beneficiary due to behavioral conditions, caregiver need or convenience:
  1. If applicable, documentation should include:
  → Evidence that the patient is at risk of falls, has impaired motor skills, poor executive function, sensory outbursts, wandering, and/or elopement; or
  → If the patient is diagnosed with a motor and/or behavioral disorder that leads to a heightened risk of injury to themselves, others, and/or property and is at an increased risk of morbidity or mortality.
  2. Documentation should include if  the caregiver has tried solutions such as:
  → Side rails, placing the mattress on the floor, medications to address seizures or behaviors, behavior modification strategies, a helmet for headbanging, removing safety hazards from the member’s bedroom, etc.
  → Detail indicating why those other solutions did not address the patient’s sleep safety needs.
  3. Documentation should address if the patient would be at risk for injury, harm, or putting themselves or others in danger without the bed.
• 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.

• The MSA-1653-B Prior Approval-Request/Authorization Form must be submitted.
• Communicate regularly with the family and providers to improve the chance of approval.