Batteries—the 6- and 12-volt types that supply the juice to operate powered wheelchairs and scooters—are a staple at growing numbers of HME enterprises, but in too many instances the energy-storing products fail to electrify the company bottom line.

Curious as to why that is? According to those who have enjoyed success with their handling of batteries, the biggest mistake a dealer or provider can make is to put cost ahead of quality when choosing which batteries to stock.

“Quality is the main consideration,” says Rick Graver, ATS, CRTS, owner of Medtech Services Inc, a well-established provider of rehab-focused DME in Reno, Nev. “We always go with the best quality battery. Under no circumstance will we substitute something inferior for the sake of profit. A quality battery will last longer. That means it doesn’t have to be replaced as often, which ends up costing the customer less in the long run. And that works out better for us too because we’re not going to have a disappointed customer to deal with.”

That is just how Ronnie King, CRTS, director of rehab at Ed Medical in Nashville, Tenn, sees it.

“You get what you pay for,” says King, whose outfit spent about $60,000 on batteries in 2002. “The price might be $4 or $5 cheaper per battery from one particular supplier compared to another. But if the quality’s not there in that lower-cost battery, your savings will be eaten up by the very first service call you’re forced to make because of a problem caused by that battery. You’re better off paying a few dollars extra for the quality battery because you’re not going to have performance problems prematurely.”

Exclusive Relationships
Another reason HME dealers and providers may not see their profit and loss statements improved by batteries has to do with their choice of product supplier. One company that has made some good decisions along those lines is Custom Mobility Inc of Largo, Fla, which elected a while back to carry but a single brand of battery.

“The company we get our batteries from offers all the sizes and types we need to meet the demands of our customers,” says Kevin M. Barry, Custom Mobility’s service manager. “We decided to have an exclusive relationship like this after many years of working with many different battery manufacturers. We settled on this one because of the quality of the product and the service they offer to support us. With them, we have fewer warranty issues.”

Custom Mobility maintains an inventory of about 80 batteries on its shelves at all times. Once a week, the battery manufacturer sends a representative over to Custom Mobility to check those stock levels and then replenish as needed. (Custom Mobility gives the manufacturer a sense of how much new stock will be needed after consulting internally produced reports showing sales trends and projections of chair-preparation timetables.) In addition, the battery manufacturer’s representative rotates the shelf stock to minimize Custom Mobility’s need to undertake time-consuming recharging procedures, Barry says.

“The batteries are brought to us 80% charged,” he says. “We have a staging area where several batteries from each size are kept fully charged so we can immediately provide them to customers.”

Medtech’s Graver also believes that developing a relationship with one main supplier is advantageous. In Graver’s case, however, he finds it necessary to allocate a portion of that business to a secondary supplier, one that is closer to home than the primary.

“From our main supplier, we get our Group 22-class batteries, Group 24s, and a few odd sizes smaller than the Group 22s,” he says. “From our other source, we get our U-1 type batteries. The reason we don’t buy U-1s from our main supplier is that we sell more U-1s than any other, which makes that inventory level harder to keep up. Our second supplier has very local distribution, so we can obtain the U-1s faster than is possible with our main supplier. As a result, we can get away with keeping fewer batteries of that type on the shelf, knowing that we can take delivery of them very quickly. That saves shelf space and avoids tying up our capital.”

Is It Really Dead?
Whether talking about sealed gel-type batteries or the kind that employ absorbed glass matting, the product once in the hands of the end user is expected to last anywhere from 12 to 18 months before needing replacement.

“Heavy-duty users typically require a new battery after about 1 year,” says Barry. “Lighter-duty users may require a replacement only once every 2 or 3 years.”

However, when a customer calls to say his battery is dead, Custom Mobility service personnel do not simply take the order for a fresh one. They first attempt to troubleshoot over the phone.

“We do this because we want to try to be sure it is in fact a battery problem—sometimes it’s not,” Barry explains. “It might be a problem with the wiring harness, or it might be a problem with the charger. But if it’s found to be a battery problem, we replace that unit with the same size battery as specified by the manufacturer. Using the correct, specified battery is essential for getting the best performance out of it.”

At United Seating & Mobility LLC in Albuquerque, NM, customers expressing a need for a new battery are steered toward gel-type batteries, even if their OEM (Original Equipment Manufacturer) battery was of the absorbed-glass-mat variety.

“With gel we have less problems; they also seem to last longer,” says United’s lead purchasing agent Kenneth Naff.

Besides, fewer manufacturers these days are selling their products with absorbed-glass-mat batteries to begin with, Naff believes.

“Those that continue using absorbed glass mat in their products are doing so because that type of battery is less expensive than the gel type,” he contends.

Naff says that when a customer brings in a chair for battery replacement, it is standard procedure there to verify the operational integrity of the charging system.

“We don’t attempt to suggest any kind of upgrade or swap-out; we only suggest a different charging system if there’s a problem with the existing one,” he says. “If we do suggest changing the charger, we recommend going to a dynamic-type charger, which uses solid-state circuitry—better generally; it’s lightweight and doesn’t get as hot during the charging process. We don’t change chargers very often. Most of them are built well enough that they last the lifetime of the chair.”

Graver’s philosophy is to use the same make and model of charger that comes with the chair or scooter, unless the customer specifically requests something different. Even so, the customer-specified replacement charger would have to meet certain criteria before it could be used.

“For example, we can’t charge a scooter battery with a charger meant to be used on a car battery—the amperage output of a car-battery charger is way too high and would severely damage a scooter battery,” he explains.

Graver notes that the most compact chargers do not seem to work as well as their larger counterparts. The smaller ones tend to get worrisomely hot during charging, and they can take longer to do the job, he says.

Medicare Concerns
And then there is Medicare, which offers a mere three codes for reimbursement on batteries. Dealers explain that those codes make it possible to get paid for the most commonly used battery sizes—U-1, Group 22, and Group 24—but make it very difficult to collect on the largest types of batteries, those classified as Group 27.

“Occasionally, a wheelchair customer requests a Group 27 battery,” Graver says. “Although the chair might have been designed to accommodate that exceptionally large battery, Medicare usually balks at paying for it. Apparently, the Medicare powers-that-be don’t see a Group 27 battery as being truly medically necessary in most instances. It’s hard to show that there is a medical need to use a Group 27 battery to get around in the home. Typically, you’ll use a Group 27 battery because you need range. You usually don’t need much range indoors.”

In such instances, Medicare customarily insists on smaller batteries being used. But that is not always the end of the story. Providing detailed documentation on the chair user’s activity levels may help Medicare officials understand why only the larger battery will suffice, Graver says.

“Perhaps,” he sets forth, “the user rides the chair to work every day or maybe even just to the bus stop. Put that in the documentation and you’re showing what this person does as part of his or her daily living. The key is to provide as much information along these lines as possible so the funding source can make a fair decision.”

If Medicare down-codes a claim for a larger battery, Graver says he appeals and uses up all possible avenues of redress. That’s just good business, he says.

King adds that when a customer comes in for a replacement battery on a chair that was not originally obtained from Ed Medical, the company will nonetheless try to run the battery buy through insurance but sometimes decides against taking the assignment, requiring instead that the customer pay up front and out-of-pocket.

“If the individual got their chair through the Internet or at a yard sale, we will not have a record of the Medicare purchase,” says King. “And if Medicare didn’t buy the chair for you, they don’t have records that your purchase qualified for reimbursement as a medically necessary item. That being the case, our claim for reimbursement on the replacement battery will more than likely be turned down.”

Awaiting Innovation
Distressing though Medicare hassles may be, some dealers and providers take them in stride. Of greater concern to them is simply making sure they supply their customers with reliable batteries that are suited to their needs. And that is why these same dealers and providers have an eye to the future—there are innovations they would like to see that could further enhance the quality of batteries and, by extension, the satisfaction of their customers.

“I’d like to see improvements in the way the battery interfaces with the chair,” Graver says. “We’re always looking for easier ways to get at the battery for removal, replacement, and reinstallation. I’d also like to see batteries made lighter and smaller but with the same amount of power and time between charges that the biggest ones now available offer.”

The one innovation Barry would most welcome is a charger that supplies amperage to the batteries as the chair or scooter is being used, much as an alternator on an automobile does while the vehicle is driving along.

“That would do away with the need to every day plug your wheelchair or scooter into the wall socket to recharge the batteries overnight,” he says. “It would also take the potential for human error out of the charging process.”

Naff, meanwhile, is confident that the quest for a lightweight, longer-lasting battery will be fulfilled. The driving force behind that quest is market pressure in the form of a mushrooming population of under-50 adults who want to extend the range of their chairs and scooters in service to their active lifestyles.

“This demographic wants to be able to go long distances between charges,” he says. “They don’t want to be slowed up in the way they live by the constraints of battery duration and recharge speed.”

Rich Smith is a contributing writer for Dealer/Provider.

Mobility Insider

K.C. Jensen What do wheelchair cushions and extruded polymer seals and gaskets have in common? Lauren Manufacturing. Founded in 1965, the company recently expanded into the medical sector with the launch of Comfortechnology by Lauren, which offers a line of wheelchair cushions and a contoured, foam pillow. Dealer/Provider spoke with K.C. Jensen of marketing at Comfortechnology, based in New Philadelphia, Ohio, about the expansion and how dealers can choose an appropriate wheelchair cushion. Why did Lauren Manufacturing jump from making polymer seals, gaskets, and weather stripping to manufacturing wheelchair cushions for the medical industry? Comfortechnology and Lauren Manufacturing’s parent company, Lauren International Inc, is a diverse organization with seven subsidiaries. The corporation has a long track record of identifying niche opportunities and then using its polymer-based technical abilities to create new products that specifically target those opportunities. In working with one of our suppliers, we began to focus on the untapped market potential for lighter-weight, durable gel cushions for long-term seating needs. Ultimately, we were able to create a hybrid gel/air/foam cushion that delivers the pressure interface characteristics of a gel cushion without all of the weight. So far, the customer response to our cushions has been very encouraging. What has been the biggest challenge in entering this market? Learning the market has been very challenging and exciting. Although Lauren has been around since 1965, we are brand-new in the medical products arena. The key for us is to keep learning every day and use what we learn to expand and improve our product line. The medical industry and the mobility and seating/positioning markets are enormous and growing, and there are a number of good companies with solid products to compete against. Our biggest challenge lies in making sure that customers understand what makes our cushions different and that they understand why we’re convinced we have a better solution for many long-term seating applications. Hopefully, they will agree with us. What is the most important element providers should look for when choosing a cushion, and what pitfalls should they avoid? No two individuals have the same long-term seating needs, so there really is no “one-size-fits-all” cushion. Our cushions cover a broad spectrum of needs as they specifically address long-term pressure relief and skin-damage prevention in a lightweight configuration, but we also know that our cushions aren’t going to be right for everyone. One other thing to note about wheelchair cushions, like just about everything else, is that you get what you pay for. There are a number of lower-end cushions that will work for a week, or even a month or two, but they don’t hold up under long-term everyday use. If a person is going to spend a significant part of his or her day, day in and day out, sitting in a wheelchair, the extra money spent on a well-designed, durable cushion will be well worth it.