Attleboro Area Medical Equipment Company
Massachusetts Prior Authorization
Requirements

MASS HEALTH (Medicaid) PA REQUIREMENTS

Prior authorizations take approximately 30 days to process after AA Medical Equipment Company has received the following items:

1.) Prescription
2.) Letter of Medical Necessity
3.) Physical Evaluation (for lightweight or heavy duty
wheelchairs and hospital beds)

Prescription for Diapers or Disposable Underpads

The product needed (adult diapers or disposable underpads)
"Two diagnosis needed" First diagnosis must be urinary incontinence due to... (second diagnosis)
The amount needed of each product per day
Diaper size
Refill quantity of one year (PA’s are done on a yearly basis and must be renewed every year.)

Must be written on physician’s letterhead
Has to state the medical reason as to why this person needs the product requested, including all applicable diagnoses
Urinary incontinence must be a primary diagnosis
Must be “urinary incontinence due to…”
State the amount needed of each item on a daily basis for an entire year
Physicians signature (Mass Health does not accept a physicians stamped signature)

Prescription for Hospital Beds and Lightweight or Heavy Duty Wheelchairs

Must be written on physician’s letterhead
Has to state the medical reason as to why this person needs the equipment requested, including all applicable diagnoses
Must list how long the wheelchair or hospital bed is expected to be used
Physician’s signature (Mass Health does not accept a physicians stamped signature)

Physical Therapy Evaluation for Wheelchairs and Hospital Beds

Must detail why this person needs equipment requested
Must list all accessories requested (i.e. elevating leg rests, removable arms, full electric bed, etc.) and why this person needs those accessories
Must list how long the wheelchair or hospital bed is expected to be used

For additional information, please call (508) 222-9146