READI-STEADI® ONLINE ORDERING
Online Ordering Requirements
The Readi-Steadi® Anti-Tremor Orthotic Glove System is a medical device. In order to comply with HIPAA regulations on the purchase of a medical device, we must take extra steps to ensure your privacy. In order to begin the self-ordering process to purchase the orthotic glove system, we require an online application form and authorization form to be completed.
Online Application & Authorization Form
The online application and authorization form will require you to have the following ready to upload or email to email@example.com
- A physician’s order for the Readi-Steadi® glove
- Clinical information from a face-to-face visit within 30 days documenting medical necessity (Click HERE for more information)
- Short video capturing tremor during set tasks
- Your insurance information
- A copy of your photo ID
- A trace drawing of patient's hand/wrist
Sample Trace Drawing. MUST be original drawing and not a photo of the drawing.
Please make sure to demonstrate the following tasks in a short video (20-30 seconds max):
Once you have completed the entire no obligation online application form below and hit submit. If you have selected to EMAIL certain attachments (physician order form, clinical notes, video, ID card, trace drawing), please do not forget to send these items to firstname.lastname@example.org. Once we receive your application, we will email you with the next steps in receiving your Readi-Steadi® Anti-Tremor Orthotic Glove System. Please be sure to check your inbox (and junk mail) and let us know if you do not receive these emails.
U.S. Online Ordering Form
Insurance & Billing Information
The Readi-Steadi® glove is custom fabricated in the USA and is covered by most major insurance companies. While most insurances cover the cost of orthotics, they do not cover the $150 assessment fee or shipping fee. Medicaid does NOT cover the glove system, however we do offer self-pay rates. Each system is custom fabricated to each individual and therefore is non-refundable.
Required Assessment Consultation
We must assess your specific needs in order to custom-fit you for the medical device. The Assessment Consultation is a separate invoiced fee of $150, is not covered by insurance and does NOT include any components of the orthotic glove system.
Just Getting Started?
Please download the required Physician Order Form, and share with your physician. Once receiving a completed order form and clinical information documenting medical necessity, you may begin the self-referral process above OR your doctor’s office may: