Documentation guide
Required Documentation and Information
Exact requirements depend on the member, requested item, payer, and current authorization guidance.
Incontinence supplies
- Current prescription or physician order
- Medical records supporting medical necessity within the past 6 months
- Current HCA-52A
- Product type, size, quantity, and current usage
- Prior authorization documentation when required
Bathroom safety equipment
- Prescription identifying the requested equipment
- Medical records describing mobility or safety limitations within the past 6 months
- Member height, weight, and equipment capacity needs
- Bathroom or installation details when relevant
- Prior authorization and manual-pricing support when applicable
Nutritional products
- Prescription specifying formula and daily quantity
- Diagnosis and records supporting medical necessity, stating nutritional need within the past 6 months
- Calories, method of administration, and unit information
- Current weight or nutritional assessment when applicable
- Program-specific authorization documentation
Personal emergency response systems
- Member safety need and service-plan authorization
- PERS request form with at least one documented fall in the past year where the member fell due to medical diagnosis and could not get up on their own
- Correct service provider selection for iMed Alert Systems
- Member physical address, phone number, and device preference
Do not submit member details through this public website.
What We Do
Here’s what the process usually looks like
- Intake
Supplies are requested by the case manager or a referral is recieved. We enter the member’s information and create the order. - Product Selection
We work with the member to determine the best product for them based on their unique needs. - Documentation
We send the HCA to the member’s physician for completion and request their medical records stating their need for supplies. - Follow Up
If we have not received the completed documents from the member’s physician, we contact them to confirm receipt. This step usually takes the most time. - Document Submission
The HCA and medical records are submitted to Title 19. - Title 19 Approval or Denial
If approved, we move to the next step. If denied, we send the denial, HCA, and medical records to the case manager to submit through ADvantage. - Authorization and Order Preparation
Once we recieve the authorization, whether through Title 19 or ADvantage, we prepare and ship the member’s first order.
SoonerCare / Title XIX
Working through SoonerCare coverage
- Coverage depends on medical necessity and member eligibility.
- Prescription, medical records, and prior authorization may be required.
- Published DMEPOS rates may differ for rural and non-rural services.
- Some HCPCS codes are manually priced.
ADvantage Waiver
Support through the ADvantage Waiver
- Services support eligible adults living safely in the community.
- Requests must align with assessed need and the service plan.
- Program-specific authorization and provider requirements may apply.
- Contact iMed for product and documentation guidance.