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Physician Referral (NOTE: MEDICAID PATIENT REFERRALS MUST BE ON WHITE PAPER, DO NOT USE SCRIPT PAD.)
Referral or script is faxed to ATS requesting a Mobility and Seating Evaluation. The Referral must include the patient’s primary ICD-10 diagnosis codes and be signed by an MD or DO. Please include patient contact information, clinical notes from a recent office visit to further establish the need for mobility.

ATS Evaluation
Upon receipt of referral, ATS will contact your patient to schedule their in-home mobility evaluation. This in home evaluation insures the equipment provided will function for your patient within their home and ease ADL challenges. The complete Evaluation will be sent to the referring physician.

Physician Review
Completed Evaluation and recommendations must be reviewed and signed by referring physician and returned to ATS with a script specifying the equipment recommended.

ATS Precertification/Authorization
Upon receipt of completed Evaluation package from physician, ATS will contact the patient’s payer source(s) for appropriate authorization.

ATS Order Finalized
When all necessary documentation is complete, ATS issues an order for the patient’s unique equipment. Lead-times vary depending upon complexity. Upon receipt, equipment is thoroughly inspected and required accessories are installed.

ATS Delivery, Final Fitting and Training
Patient is contacted to schedule delivery, final fitting and training. This appointment also includes review of warranty coverage, our local service/repair process and verification the patient is comfortable and confident of all operating aspects.


*The process outlined above will vary depending upon your patient’s primary and/or secondary insurance carriers.

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CARF GoldSealAssistive Technology Solutions
A Division of the Easter Seals Rehabilitation Center
3701 Bellemeade Avenue
Evansville, IN 47714-0137
Phone (812) 492-0659 Fax (812) 437-2611