Steps To Work With Your Doctor & Therapist for zPods

1. Patient Intake Form 

Physical exam and chart notes supporting the medical need for the zPod Safety Bed.

1. Letter of Medical Necessity

A Letter of Medical Necessity (LMN) is a written letter of explanation by your child's treating

physician, specialist or therapist describing the medical treatment for the patient's care.

These letters explain the patient’s specific needs and why a zPod Safety Bed is medically

necessary. Please note, If the LMN is written by the patient’s Occupational Therapist or

Physical Therapist, the prescribing doctor will need to sign as well. See what to include in the

LMN below:

LMN’S for zPod Safety Bed should include:

● zPod Safety Bed prescribed by the treating physician

● Medical explanation demonstrating the need for the zPod Safety Bed

● Medical rationale and diagnosis linking the requested zPod Safety Bed to the

patient's condition

● Evidence of a physical exam performed and office visit notes from the past year

1. Prescription (Rx)

A written Rx from Primary Care Doctor/Pediatrician specifically stating a zPod Safety Bed. Please see attached written prescription template to use for a zPod Safety Bed.

1. Written Order

A written communication from a treating practitioner that evaluates and documents the need and safety concerns for a patient to be provided an item such as a zPod Safety Bed.

1. Patient Documentation

Physical exam and chart notes supporting the medical need for the zPod Safety Bed.

1. Copy of Insurance Card

If your child has Primary Insurance coverage, we will need a copy of the front and back of the card. If your child has Secondary Insurance Coverage also, we will need a copy of the front and back of this card as well.

Supporting evidence of medical need for a zPod Safety Bed.

Parental/Caregiver Personal Experience Letter. 

May also include pictures, videos as to the medical need of a zPod Safety Bed.