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By Nicole Usher, Senior Director, Operations
Not all durable medical equipment (DME) referrals are completed at purchase. Some include warranties that need to be monitored and maintained, including items like wheelchairs, respiratory equipment, prosthetics and patient lifts.
Medical equipment warranties consider healthcare-specific factors and are dependent on device complexities involving multiple components. They cover defects, failures, repairs, replacement, and can include technical support and prorated refunds. All of which, if not managed, can drive up the cost of a workers’ comp claim.
What’s Required from Adjusters
As the originating approver for medical equipment purchases, adjusters are trusted with remembering the intricacies of the warranty process as well as whether they were assigned to the claim at the time the equipment was ordered. Maintaining these warranties includes:
- Verifying warranty coverage before approving replacements
- Ensuring warranties are utilized before authorizing repair payments
- Coordinating warranty-related issues
- Documenting device information in the claim file
Warranty Management
It’s one thing to have a warranty, and another to proactively manage it, especially as an adjuster handling multiple claims entailing countless equipment items. Warranty management programs remove this burden by providing visibility into equipment lifecycles, so adjusters don’t have to actively track them. These programs:
- Monitor warranty start and end dates, coverage details, and claim item information
- Coordinate between adjusters, case managers, service providers and manufacturers
- Facilitate repair and replacement or arrange temporary equipment
Special Warranty Care Considerations with Prosthetics
Warranty management is particularly crucial for prosthetics due to their customized nature and impact on patient mobility and quality of life. Often prostheses warranties are managed by the prosthetic/orthotic clinics that fabricate and fit these devices. These warranties can be complex, involving multiple components with tiered coverage including:
- Structural components
- Mechanical joints
- Electronic components
- Cosmetic coverings
- Socket fits
Why Warranties Matter for Workers' Comp Claims
In workers’ compensation warranties are essential for long-term equipment management. They reduce overall claim costs and equipment leakage. Documentation provides information for future decision-making regarding equipment, and warranties also support:
- Reduced downtime: Faster repair/replacement to prevent interruptions in care
- Minimize costs: Avoids unnecessary repurchases when items are under warranty
- Extend equipment life: Ensures proper maintenance and service
- Continuity of care: Injured employees are not waiting for essential equipment
Workers’ Compensation Challenges
Handling workers’ compensation claims with warrantied medical equipment can be difficult. Claims can remain open for decades, outlasting many warranties. Cases may transfer between multiple adjusters over time, complicating warranty tracking. Warranty information may not be consistently captured in older claims systems creating documentation gaps. These challenges make tracking equipment, patients and claims collectively pivotal for long term management.
Final Takeaway
Warranty management adds a layer of accountability that protects your injured employee’s equipment long after the initial order. Specialty providers, like Apricus, coordinate durable medical equipment referrals that also include warranty tracking at no additional charge for the life of a claim to ensure ongoing oversight, financial protection, and service continuity.
About the Author
Nicole has 17 years of experience in the workers’ comp industry and has held multiple leadership positions including roles in finance, quality, and operations. With a longstanding knowledge of quality service delivery, she instills these values within her team, partners, and clients.
Nicole is also a regular contributor to our Specialty Solutions Spotlight where this article originally appeared. To ask and find the answers to more work comp specialty questions visit the Apricus website and subscribe to our monthly series.
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About The Author
About The Author
-
Nicole Usher
Nicole Usher has 15 years of experience in the workers’ comp industry and has held multiple leadership positions. As an operational leader, Nicole promotes innovative ways to provide superior client experiences that adhere to the complex nature of the industry, state regulations, and the needs of claims professionals. She is also the author of a three-part series on hospital discharge planning, of which the above piece is a synopsis from part one. To read more from the series on how hospital discharge planning can improve workflows and outcomes, visit: www.apricusinc.com/hospital-discharge-planning.
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