5 Tips For AAC Funding

Do you know the ins and outs of funding for your speech-generating device (SGD)? At PRC-Saltillo, we understand the process and will work with you to ensure success. Follow these 5 tips to get started.

Organize Your AAC Team

One of the first steps to begin the search for a SGD and obtaining funding is to meet with clinical professionals who will help match a client with the device and accessories that meet their specific needs. Members of this team include:

1. The future client of the device and medical decision maker (if other than the client)
2. An ASHA-certified speech language pathologist (SLP)
3. Client’s physician

These individuals comprise the core team. Other individuals to consider include:

1. Family members or caregivers
2. Occupational or physical therapists
3. A teacher or a rehabilitation counselor

Verify Your Insurance Funding Information

Once your AAC team is in place, it’s recommended to check funding sources. You will need to verify the client’s funding source and coverage for a SGD. This could be private insurance, Medicaid, Medicare, military coverage, or a combination. Follow our insurance funding tips here.

Be prepared with the following information for a conversation with insurance providers:

1. Policyholder’s name and ID number
2. Plan group number
3. The client’s name, date of birth, and diagnosis

It is important to also ask these questions:

1. Does the policy cover durable medical equipment, more specifically, SGDs? Are the following codes a covered benefit: E2510, E2599, & E2512?
2. Is a physician’s referral required?
3. What are the in-network and out-of-network benefits?

Once the answers to these questions from all policies have been obtained, keep the information in a safe place with the Assignment of Benefits (AOB) form which must be signed by the policyholder.

Complete Your AAC Evaluation

To ensure that a communication device will be funded, schedule a full and comprehensive AAC evaluation for the client. This evaluation must be completed by the ASHA-certified SLP on your AAC team.

The purpose of this evaluation is to be the single source of truth for medical justification of all recommended equipment. For a full list of evaluation requirements, visit the Regional Medical Review (RMRP) guidelines.

Acquire a Certificate of Medical Necessity

Upon completion of the AAC evaluation and physician appointment within the last six months, a client will receive a certificate of medical necessity. This certificate lists the equipment recommended for the AAC communicator and other various requirements. Be sure to complete the CMN in it’s entirety.

Keep in mind, the certificate must be signed and dated by the prescribing physician after the AAC evaluation is signed.

AAC Funded Device Selection

Now it’s time to submit your application. At PRC-Saltillo, we provide an optional trial device program. Keep in mind, if a trial is recommened, an SLP evaluation and CMN are only needed by certain funding sources, not all. If a trial device is not desired or required by the funding source, the application process may begin.

During the application process the assignment of benefits, AAC evaluation, and certificate of medical necessity/prescription will be required. At this point, you will complete the web version of the equipment selection sheets.

Once the application has been submitted, our funding staff will review and contact the client ‘s medical decision maker with any questions. Throughout the approval process, clients or their team may check the status of their application here. Questions may be directed to funding@prc-saltillo.com or 800.268.5224.

By following these tips and working with the PRC-Saltillo Funding Department, you’re on your way to communication with an AAC device. Ready to get started? Visit aacfunding.com