AAC Funding – How To Obtain Funding

How To Obtain Funding

The PRC-Saltillo Funding Department is experienced at navigating the rules, requirements and potential pitfalls involved in working with so many different providers.

We understand the process and will work with you to ensure success.

We are guided by our dedication to our mission: Because everyone deserves a voice.

  Download our Funding Quick Reference Guide.

 

Necessary team members:

  • Client
  • Medical Decision Maker (if other than the client) 
  • Qualified Evaluating Speech-Language Pathologist (SLP)
  • Client’s doctor

Other possible team members:

  • Family/guardian/caregiver
  • Occupational therapist
  • Physical therapist
  • Teacher
  • Rehabilitation counselor

Find out what type(s) of health insurance coverage the client has, so you can determine if their insurance provides coverage for a speech generating device (SGD).  This can be anything from state Medicaid to Medicare, commercial insurance to Tricare (military coverage) – or a combination of these. If an SGD is not a covered benefit, alternate funding sources will need to be explored.

When talking with the insurance provider, be sure to have:

  • Policyholder's name and identification number
  • Group number
  • Client's name, date of birth, diagnosis

Most importantly find out if: 

The insurance policy covers durable medical equipment (DME) or, more specifically, speech-generating devices (SGD).

Ask if the policy covers the following codes:

  • E2510 (SGD)
  • E2599 (SGD Accessories)
  • E2512 (Mounts)

Also be sure to find out:

  • If the procedure/HCPCS code is a covered benefit
  • About in-network and out-of-network benefits
  • If a physician's referral is required

A full and complete AAC evaluation is the key to ensuring that a communication device will be funded. The evaluation MUST be completed by a Qualified Evaluating Speech-Language Pathologist (SLP). 

Regional Medical Review Policy (RMRP) Guidelines* require that the following information be documented in the AAC evaluation report:

  • Client’s Background Information
  • Speech and Language Abilities
    • Receptive
    • Expressive
  • Cognitive Abilities
  • Physical Abilities
  • Mobility Status
  • Hearing and Vision
  • Daily Communication Needs
  • Rationale for Device Selection
  • SGDs Considered and/or Tried
  • Recommended SGD and Accessories
  • Functional Communication Goals
  • Treatment Plan, Disclosure, and Signature

Please be sure the report is signed!

*Please note: Medicare and most funding sources follow these guidelines, as well.

The easiest and fastest way to complete a funding application is at https://portal.aacfunding.com/login 

      • Create a PRC-Saltillo account or Login
      • Select Start a New Application
      • If you need a trial device from us, start an application for a trial device. If not, start an application for purchase.
      • Complete the following:
        • Client Information
        • Insurance Information/Assignment of Benefits
        • AAC Evaluation (must be completed by a Qualified Evaluating Speech-Language Pathologist)
        • Certificate of Medical Necessity/Prescription (must be signed by doctor)
        • Equipment Selection
        • Any additional items deemed necessary by the PRC-Saltillo Funding Department
      • Once all of the sections are complete, you will be able to Submit your application to be reviewed by our funding staff.
If you are not able to complete your application online, applications may also be submitted via fax or mail service:
    • PRC-Saltillo Funding
    • 1022 Heyl Rd.
    • Wooster, OH 44691
    • Fax: 330.202.5840

Do not email application documents unless your email server is encrypted!

Once we receive your application, our funding team gets to work. They will:

        • Review the application
          • verify the client’s insurance eligibility
          • review all documentation and contact the SLP or family for missing information
        • Submit to insurance
          • ensure the application is sent to the proper funding source(s)
        • Wait for the insurance ruling
        • Document/communicate insurance ruling
          • Celebrate approval!
          • If necessary, manage deferrals or denials by working with the client/medical decision maker/SLP to appeal
        • Confirm approved orders prior to shipment
          • Respond quickly to expedite this process!

Be patient, but persistent. Login to https://portal.aacfunding.com/login to check on the status of your application. If you have specific questions on missing information, contact our Funding Department.

  • funding@prc-saltillo.com or (800) 268-5224
  • Please use an encrypted email service to send documents with PHI. Regular email does not meet HIPAA requirements for protecting PHI.

Make sure all paperwork is filled out completely.

Common issues that hold up an application include:

  • Missing policy holder signature on AOB
  • Missing SLP signature on AAC evaluation
  • Different items being requested across AAC evaluation, CMN/prescription, and equipment selection sheet. The equipment must be the same in all three places.

    Congratulations!

    Once your AAC device has arrived, notify your team of the good news.

    After opening the box, review the contents. Double-check that everything you’ve ordered is enclosed.

    Attach any accessories to the device, and then turn it on. If it needs to be charged, plug it in.

    Set the device to the recommended vocabulary, choose a voice and then set and adjust the access method (if needed) so the client can make selections on the device accurately and efficiently.

    If at any point you need assistance, contact your PRC-Saltillo Consultant. He or she will provide training on device setup, operation and implementation.