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Physician's Manual
How to Complete a Request for a Motorized Wheelchair  
 
 
 
 
 
 
 


Please Note

     If your patient needs help in the home with their activities of daily living (ADLs), then they may qualify for a power wheelchair under current Medicare guidelines. Medicare requires specific information in order to complete a request for a power wheelchair. 

     It is not uncommon for a physician to submit detailed chart notes but still omit specific information required by Medicare.  So to expedite the process, we have provided you with the "Easy Questions" and other reference documents to help you complete your patient's request for a power wheelchair.  I will also be happy to answer any questions that you or your staff may have about our paperwork and/or Power Wheelchairs.

 
 
 
 
   
 
 
     
 
Cliff Belleau
Source One Medical
C: 586.549.0583
cbelleau@sourceonemedical.org
6560 Palms Rd.- Fair Haven, MI 48023
 
 
 

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Organizational Skills For Power Wheelchair Representatives