Referral and procurement tools

Which route to use

The therapy and case management referral is for OTs, PTs, wound-care nurses and case managers placing a referral for a client. It sets out what to send, what we check, and the explicit list of what we will not decide on your behalf.

The discharge planner express request is for hospital social workers and transition coordinators with a date in hand. It also contains the fullest account on this site of how equipment actually gets approved — the face-to-face evaluation, the Standard Written Order, the medical-necessity documentation and the proof of delivery — and where a Dolphin FIS sits relative to that path, which is outside it.

VA and facility leases is for procurement: what a lease covers, what clinical engineering will want at intake, what we need to quote per receiving site, and a plain statement of the contract vehicles we do not hold.

• Therapy and case manager referral — for OTs, PTs, wound-care nurses and case managers
• Discharge planner express request — for a date-driven transition out of hospital
• VA and facility leases — for institutional procurement and multi-site deployments
• Insurance and funding guides — the categories, the criteria, and what to ask a payer

The funding position, so nobody has to ask twice

We do not bill Medicare, Medicaid or commercial insurers, and we do not submit claims. Fluid immersion simulation has no HCPCS code of its own. Medicare’s Group 3 code, E0194, describes an air-fluidized bed — warm filtered air through silicone-coated ceramic beads — and a Dolphin FIS is not that mechanism; Joerns describes its system as delivering many of the best elements of air-fluidized therapy, which is a comparison and not an equivalence. At least one major commercial payer classifies fluid immersion simulation as experimental, investigational or unproven and considers it institutional equipment inappropriate for home use.

So the funding routes are private payment, a facility purchase order, VA contracting, or an HSA or FSA claim supported by a Letter of Medical Necessity that your side writes and the plan administrator decides on. That is the complete list, and we would rather you had it before you place a referral than after.

Where a covered Group 2 surface would meet the clinical need, that is the better answer for the patient: coded, billable through an enrolled DME supplier, and cheaper. We say so when it is true.

What we will say about the equipment, and no more

Joerns describes fluid immersion simulation as automatically simulating a fluid environment, maintaining near normal blood flow, minimizing soft tissue distortion and optimizing tissue oxygenation, and states that it is highly effective for the prevention and healing of pressure injuries through Stage 4 as well as for treating patients with post-operative flaps and grafts. It adds that the system may also be used for patients whose medical condition precludes turning and repositioning, or where those interventions may be contraindicated, and for patients with spinal cord injury once the acute injury has been stabilized and the patient has been cleared by a physician.

And it closes with the sentence that governs every clinical claim on this site: Joerns clinical indications are guidelines and should be taken only as recommendations for consideration during individual patient assessment by the clinician. We publish no outcome percentages, no healing times and no patient stories, because none exist in any source we can show you.

Trials, and surfaces already in service

Trial requests come mostly from facilities and from clinicians building a case. Tell us what you need to observe and over what period and we will scope what is genuinely available against stock and freight rather than agreeing in principle to something that cannot be resourced.

If a surface we supplied is misbehaving in a home or a unit, come to us directly. Most reported faults resolve to three things: a control unit unplugged, a system that has been off mains power longer than the battery’s approximately twelve hours, or a storage switch left out of the battery-on position so the battery never recharged.