NRRTS Launches Guidelines for CRT Repairs

• By Laurie Watanabe
• Sep 21, 2023

The National Registry of Rehabilitation Technology Suppliers (NRRTS) has released practice guidelines for providing Complex Rehab Technology (CRT) service, preventive maintenance, and repairs.

In the Sept. 16 announcement about the guidelines, NRRTS Executive Director Weesie Walker, ATP/SMS, said, “Difficulties in providing and receiving CRT service and repair have become challenging to all stakeholders. The various influences that challenge access to necessary service and repairs are the subject of much discussion, and it is difficult to reach understanding between those most impacted.”

Walker referred to a number of ongoing challenges, including “repair times, level of reimbursement for service and parts, in-home service capacity and feasibility, hiring and securing qualified staff, [and] procedural complexity.”

“Considering the reported loss of revenue associated with repairs, increased complexity of power wheelchair designs, and onerous policies regarding repairs, it is understandable that suppliers are under significant pressure, and consumers are dissatisfied,” Walker said.

A Solution Involving All Stakeholders

NRRTS believes all stakeholders will need to work together to move forward, even though CRT providers and manufacturers are usually the ones who bear the brunt of consumer frustration over lengthy repair timelines.

Suggestions in the guidelines included CRT suppliers establishing best practices for repair and investing in training their technicians. Manufacturers have been called upon to improve wheelchair owners’ manuals to include recommended preventive maintenance, “including the level of technical expertise required to perform each step.”

Meanwhile, funding sources are called on to scrutinize prior authorization requirements and to streamline or eliminate them; to simplify and standardize their repair documentation requirements; and to communicate with suppliers concerned with inadequate reimbursement for replacement parts, time and fuel used while commuting to consumers’ homes, and time spent diagnosing and servicing the equipment.

“All stakeholders, suppliers, manufacturers, clinicians, consumers, and payors should work together to identify barriers to timely and professional repairs and agree on initiatives to influence positive change,” Walker said in the announcement.

The first step towards resolution, she added, is the standards document, created by NRRTS in collaboration with the University of Pittsburgh and other industry experts.

A Broad Range of Responsibilities

The guidelines were written by Mark R. Schmeler, Ph.D., OTR/L, ATP; Jack Fried, MRT; Richard M. Schein, Ph.D., MPH; Gede Pramana, Ph.D.; Madelyn Betz, MRT, ATP; Weesie Walker, ATP/SMS; Mark Sullivan; and Rita Stanley.

The document addresses three main areas within the topic of wheelchair service: efficiency, documentation, and prevention and replacement.

The guidelines cover CRT service methods, including discussion about the most efficient location for wheelchair repairs to take place (i.e., the provider’s office) and other options (e.g., use of mobile repair vans) when getting to the provider’s office isn’t possible. The guidelines also discuss using remote service technology to give providers a virtual look at the equipment needing repairs before actually sending a technician out the door.

The standards discuss the benefits of preventive maintenance and repair, and how all stakeholders — consumers, providers, manufacturers — would be key to optimizing clear communications, expectations, and knowledge of, for example, reasonable useful life expectancies of components. The document also discusses the types of systems and components that would be included in a preventive maintenance model, and which components (e.g, batteries, casters, upholstery) should be expected to need replacement due to everyday wear and tear.

Payers’ responsibilities, as suggested by the guidelines, would include developing documentation requirements that would be consistent across different funding sources, as well as changing prior authorization and documentation requirements for “wearable items” (e.g., forks, bearings, batteries) that are “expected to fail periodically,” and providing payment for preventive maintenance as described by wheelchair manufacturers.

Read the new standards and Weesie Walker’s opening remarks here.

The standards were developed under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research.