RESOURCES
Provider Forms And Documents
Everything a practice or prosthetics department needs to prescribe, order, and get started with Encora X1. All files are PDFs, ready to download, print, or share.
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Medicare, Commercial Insurance & Self-Pay
Assessment tools and how to prescribe through neurology, movement disorder clinics , primary care providers
Veterans Administration and Federal
Prescribing, ordering and fulfillment through the VA
The device, the evidence and safety information
PRESCRIBING AND COVERAGE
Medicare, Commercial Insurance, And Self-Pay
Prescriber checklists, prescription form, insurance, and signed agreement together.
Prescription Submission Quick Start
What to send, where to send it, and the contacts for each step.
RX-001 REV 3 · 2 PAGES
Assignment of Benefits
Patient signature page assigning benefits and authorizing release of information.
RX-004 REV 3 · 1 PAGE
BF-ADL Assessment
Bain & Findley scale used to establish baseline and document improvement.
RX-005 REV 2 · 1 PAGE
Standard Written Order
The prescription form for Medicare, commercial insurance, and self-pay patients.
RX-003 REV 3 · 1 PAGE
Insurance Coverage Checklist
Documentation required at initial coverage and at the 60-to-91-day Medicare re-evaluation.
RX-002 REV 4 · 2 PAGESVETERANS HEALTH ADMINISTRATION
VA And Federal
Federal procurement supported by Lovell Government Services. Resources cover prescribing, product fulfillment, sizing, and VA ordering support.
VA Provider Quick-Start
Clinical and product guidance from patient evaluation through VA submission, including suggested PSAS consult language.
RX-006 REV 4 · 2 PAGES
Optional Encora X1 Prescription Form
Optional form to capture the product and patient information needed to fulfill Encora X1. VA facilities may use their own documentation.
RX-007 REV 4 · 1 PAGE
Wrist Measurement Guide
How to measure a wrist and select the band size, with a printable measuring strip.
RX-009 REV 1 · 2 PAGES
VA Prosthetics Product & Fulfillment Guide
Encora X1 product, fulfillment, sizing, bilateral prescribing, replacement, and support information for VA Prosthetics teams.
RX-011 REV 0 · 2 PAGESEVIDENCE AND PRODUCT INFORMATION
Product and Clinical
Learn more about Encora X1 clinical trial data, get the operating detail you need before a first prescription, and leave something in the waiting room for patients still deciding.
COMING SOON
Instructions for Use
Complete indications, contraindications, warnings, precautions, and operating instructions.
RX-001 REV 3 · 2 PAGES
Clinical Evidence One-Pager
Two-page summary of responder rates, safety, and study design.
MKT_002 REV 1 · 2 PAGES
Clinical Evidence Whitepaper
Full ULTRE and 90-Day Home Use study results, methods, and endpoints.
MKT-001 REV 0 · 1 PAGE
Patient Brochure
Eight-page introduction for patients and caregivers, written for the waiting room.
MT-003 REV 2 · 8 PAGESWEB-021 REV0