Referrals
Referrals
Every patient deserves a seamless, integrated partnership across their care journey. Our purpose is to be your partner helping patients achieve a life without limitations.
How to
How to Refer Your Patients
Referring your patients to ForMotion for a free consultation is designed to support both you and your patient every step of the way. Our goal is to ensure a smooth experience, timely care, and trusted collaboration throughout the entire treatment process.
Step 1
Send a prescription to the local ForMotion Clinic, complete with diagnosis codes and supporting notes.
Step 2
You contact the patient's local ForMotion Clinic to schedule a free consultation.
Step 3
Our certified orthotists and prosthetists will evaluate and fabricate and/or fit the prescribed device to your patient.
Step 4
Your patient is scheduled for a follow-up visit.
Ordering
How To Order Prosthetics or Orthotics
Step 1: Fax the following items
- Patient Demographic Sheet. Must include phone, address, and date of birth (DOB).
- Patient Insurance Card(s). Copy of Insurance Card (front and back).
- Office Visit Notes. Last 30–60 days of office visit notes. Attention: Medicare and Commercial Payors require a Physician’s signature to be on the last page of each office visit note.
- Signed Prescription. A ForMotion Clinic prescription sheet or a signed diagnosis and evaluation.
Medicare Patients
Key clinical documentation elements Medicare requires
Referring Medicare Patients for Prosthetic Care
A smooth referral process helps prevent delays, added costs, and frustration for your Medicare patients. Clear, complete documentation that meets Medicare requirements is essential to ensure timely approval and uninterrupted care.
Medical necessity and clinical rationale
The physician must document the patient’s diagnosis, clinical status, and how the prosthesis will improve functional ability. Simply stating a desire for ambulation is not sufficient without clinical justification.
Current and expected functional ability
Records should describe the patient’s present functional limitations and expected functional potential — often using Medicare Functional Classification Levels (K-levels) — with explanation if current and expected levels differ.
Physician order (Standard Written Order)
A detailed written order must be furnished that includes beneficiary identification, item description (narrative, HCPCS code, or model), and the clinician’s signature before delivery.
Supporting clinical findings
Documentation should include objective, patient-specific exam findings and evidence of other therapeutic interventions and outcomes to support why the chosen prosthetic device is reasonable and necessary.
Prosthetist/orthotist records
Documentation from orthotists or prosthetists is considered part of the medical record and can support the physician’s documentation but does not replace the physician’s clinical justification.
Resources
Resources
Here, you’ll find information and insights designed to help you understand your choices and get the care you need for your own journey through life, wherever it leads.
Clinics Near You
Partner With Your Local ForMotion Clinic
We have a growing network of Orthotic and Prosthetic clinics. Find the location closest to you for more information on how to partner with us.
