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Medicare claim denied: Man may lose his Hoveround after 4 years of using it

5:13 PM, May 31, 2013   |    comments
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JACKSONVILLE, Fla. -- It is difficult to miss Leon Exum: He's the one going back and forth in his Hoveround powered wheelchair with a flag flying on the back of it.

"I was hurt in 1979 on a construction job," said Exum, "I had three tons of steel fall on me that took out my ankle, my knee and my hip."

Exum, 62, said he has been disabled since his accident. The former construction worker said since 2009, he has used a powered  wheelchair, but now he may have to give it back.

"They're threatened to come and pick it up and I will be stranded," he said. 

This week, Exum was notified by Hoveround, the manufacturer, that his 2009 Medicare claim was denied.

"The default is on them. I have been on the phone with Medicare for the last three days," said Exum.

Why now, after four years? The company said the claim has been appealed five times and each time it was denied, the latest being March 2013.

"We have done our due diligence," said Debra Silvers with Hoveround.

Silvers said Hoveround exhausted the appeal process with this claim. For HIPPA or privacy law reasons, she could not discuss the specifics of the case. 

Apparently, Medicare is not convinced the chair is medically necessary. Exum refuses to accept that as the reason for him losing his chair.

"I'm not giving up the chair," he said defiantly.

Exum said the powered wheelchair he has used since 2009 is not a convenience, it is a necessity.

"I do feel I am entitled to keep this chair," said Exum, "I most certainly do."

Silvers with Hoveround said Exum has a few options:

1) He can go back to his doctor for more documentation to show the chair is medically necessary; a face to face mobility assessment.

2) He can purchase the chair for cash outright

3) He can let the company recover the asset at no charge to him for the use of it.  

First Coast News

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