Pride Mobility Products Corp.
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Pride Mobility REF: COM/0106-1
Rev.: B Effective Date: 8/1/16
Approved by: Julie Piriano

Pride Provider Standards Attestation Form

Please read the below standards and complete the form below.
Provide current company contact information.

Pride Mobility Products Corporation Provider Standards
Effective August 1, 2016

These guidelines have been established to protect Pride Mobility Products Corporation's reputation as the company that delivers the industry's premium brand of products. This document was developed to ensure that entities providing Pride products understand and adhere to set standards for the benefit of all providers and consumers alike.

. All Pride providers that were authorized prior to August 1, 2016 will be grandfathered in as a Pride provider but must abide by these updated standards to retain their status which allows them to purchase and resell Pride products. In addition to periodic reviews undertaken at Pride's discretion, all Pride providers will be evaluated on an annual basis to ensure their full compliance with these standards.

In order for any entity to be considered for status as an authorized Pride provider, it must fully comply with all of the following criteria:

  • The provider must maintain a commercial business location consistent with the needs of their business activities and customers.
  • The provider must establish an account with Pride, which includes a minimum credit limit, minimum initial purchase and minimum annual purchases so that prompt delivery and service to consumers may be assumed.
  • With respect to each interaction with a consumer purchasing a Pride product, the provider must assume responsibility for careful product selection, fitting, delivery, set-up and instruction. This includes, but is not limited to, providing the consumer (as well as the caregiver, where appropriate) with clear instructions relating to the safe use and potential hazards of products and accessories as well as information regarding product care and maintenance. In addition, the provider must properly deliver all Pride product and/or accessory manuals, instructions and warnings. The provider's goal in each consumer interaction must be to assure a safe, reliable experience for the consumer when utilizing a Pride product or accessory.
  • The provider must regularly review the Pride provider website and otherwise maintain a current working knowledge of all Pride product technologies.
  • The provider assumes all responsibility for repair services for all Pride products and accessories sold, and the provider must maintain sufficient resources to provide such repair services (i.e., service what you provide).
  • The provider's advertising must clearly identify it as an authorized Pride provider and in no way portray or imply that they are the manufacturer of a Pride product or accessory.
  • No advertising may make claims beyond Pride's standard written specifications, warranties, instructions, policies and procedures.
  • Any product advertised below Pride's Minimum Advertised Price (MAP) in any and all media violates the MAP policy and is strictly prohibited.
  • Only authorized providers may advertise Pride products online for the purpose of education.
  • It is each provider's responsibility to ensure that all requirements for third-party payers are met, when applicable, for the resale of all Pride products.
  • The provider and all individuals employed by the provider must remain committed to compliance with all applicable federal and state laws governing the sale and delivery of Pride products, including, without limitation, Medicare and Medicaid compliance and in particular, but not limited to, Medicare-published DMEPOS Supplier Standards as they may be amended from time to time. The provider must not be excluded from a federal or state healthcare program.

Internet and E-Commerce Provider Standards

  • Pride providers seeking to make Pride products available for sale online must also be in compliance with Pride's Internet and E-Commerce Provider Standards and complete the attestation form online and available at www.pridemobility.com.

Minimum Advertised Price (MAP) Policy

  • Pride's MAP policy shall apply to the advertised price of certain Pride products, which may change from time to time at Pride's sole discretion. The MAP policy does not constitute an express or implied agreement between Pride and any provider or reseller of Pride products and Pride does not seek and will not accept any express or implied agreement from any provider regarding the policy. Pride shall unilaterally enforce its policy and reserves the right to deny or deactivate a provider that does not adhere to Pride's MAP policy.
  • Pride's MAP policy is available at www.pridemobility.com.

Drop Shipment Guidelines

  • Pride providers may request drop shipments of certain Pride products upon strict adherence to Pride's drop shipment policy available at www.prideprovider.com.

Quantum Rehab Provider Standards

  • Quantum Rehab Products are considered to be Group 2 PWCs with single power options and above (K0835 – K0886), all power positioning systems and all alternate drive control devices.
  • An authorized Pride provider may only purchase and resell Quantum Rehab Products if additional criteria are met, including that the provider is in compliance with the Quantum Rehab Provider Standards and after an attestation form, available at www.pridemobility.com, www.quantumrehab.com, or www.prideprovider.com is completed and approved.

Pride Provider Attestation Form

Company Name:
Account Number:
  (Please put pending if account number not yet assigned)
Company Address:
Street:
City: State: Zip:
Company Phone:
Company Fax:
Company Contact Email Address:
Are you a Medicare Provider? Yes No

NPI Number:

Person's Name Completing this Application:
Date: 9/29/2016

To further ensure compliance with these guidelines, we have implemented a process where violations may be reported to Pride’s Compliance Department by completing the appropriate Violation Notification found at www.pridemobility.com or www.prideprovider.com. In addition, a compliant may be submitted by email to compliance@pridemobility.com for further investigation. Please note if you alert us to a violation, you will not receive a response regarding the outcome of our investigation and, if applicable, any action taken against the violator.

Pride Mobility Products Corporation shall be responsible for the administration, tracking and enforcement of this policy, as well as ongoing compliance with its terms. All inquiries regarding the Pride Provider Standards must be addressed to Pride's Compliance Department via email: compliance@pridemobility.com

Pride Mobility Products Corporation reserves the right to deny, terminate or otherwise deactivate a provider’s status as an authorized Pride provider at any time for any reason at Pride’s discretion. If denied, terminated or otherwise deactivated, a provider will be prohibited from purchasing Pride products for resale.

By clicking here I agree to the terms and conditions of this agreement (electronic signature)

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