EmpowerRide Navigator™
LMN Guide
ABOUT THE EMPOWERRIDE NAVIGATOR
Letter of Medical Necessity
(LMN) Guide
The EmpowerRide Navigator is a pediatric manual mobility device intended for caregiver assisted mobility and structured seated positioning for children with mobility limitations. The device supports pediatric users who require medical mobility assistance in medical, community, and daily living environments. The Navigator provides adaptive seating support, postural positioning, and caregiver assisted mobility designed
Engineering Excellence
When A Letter Of
Medical Necessity Is Required
Insurance providers and DME suppliers may require a Letter of Medical Necessity to document the patient’s condition, functional limitations, and clinical need for the device.
The LMN Should Demonstrate:
- Functional mobility limitations
- Inadequacy of less complex equipment
- Medical necessity of the requested device
- Expected improvement in safety or function
Required Clinical Documentation
- Physician prescription or order
- Letter of Medical Necessity completed by physician, PT, or OT
- Clinical evaluation documenting mobility limitations
- Patient diagnosis and functional assessment
- Supporting medical records as required by payer
Key Medical
Necessity Elements
Diagnosis and clinical history
Functional limitations affecting activities of daily living
Need for positioning or mobility support
Why alternative equipment is not appropriate
Expected clinical benefit
Insurance &
Coverage Process
Patient evaluation by physician or licensed clinician
Prescription and Letter of Medical Necessity completed
Documentation submitted through a DME provider
Coverage determination by insurance provider
DME
Provider Pathway
The Navigator is distributed through qualified Durable Medical Equipment providers. Coverage and payment are determined by the patient’s insurance plan and clinical documentation.
Important
Notice
Coverage decisions are determined by individual insurance providers based on medical necessity and plan benefits. The Navigator is not a consumer retail product and is provided through medical equipment distribution pathways.