There are many resources available to assist with and fund communication supports, services and systems. It is important to keep in mind that funding does not only apply to a device or system itself, but also to the supports, services and repairs that may be needed to keep the device/system operating and functional.
Communication supports, services and systems funding is made available through school districts, Medical Assistance State Plan, Private Insurances, and/or the Office of Vocational Rehabilitation. The Consolidated Waiver, P/FDS Waiver, Autism Waiver or Base Allocation funding are payers of last resort for communication services, supports and systems when all other relevant funding sources have been exhausted. Other potential funding sources include foundations, grants, funds and charitable organizations.
- The Pennsylvania Assistive Technology Foundation (PATF) offers affordable cash loans to get “assistive technology into the hands of those who need it”. Interest rates are lower than traditional bank rates, and extended repayment plans are offered for those who qualify. The PATF also offers information about other potential funding sources. Contact PATF by calling 1-888-744-1938 or by visiting their website.
- The Disability Rights Pennsylvania (DRP) is a non-profit statewide public interest law firm that provides legal assistance and other services to individuals with disabilities, their organizations, their families, and their advocates. DRP’s main purpose is to advocate for the civil rights of persons with mental and physical disabilities, especially their right to live as integral parts of their communities. DRP identifies systemic issues which are important to people with disabilities and seeks change and reform through litigation, administrative advocacy, and public education. DRP has offices in Philadelphia, Harrisburg and Pittsburgh. They have a number of online publications that provide general information about funding assistive technology (AT) for individuals with disabilities. Publications include a general overview of AT for persons with disabilities, information about the appeals process, device funding for children, how to pay for the device or service you need, exceptional durable medical equipment, and other publications including information about AT and AAC funding for individuals with disabilities. DRN has created these publications for informational purposes only. To contact them directly call 1-800-692-744; 215-789-2498 -TTY or visit their website for more information.
- Client Assistance Program (CAP) offers assistance to those having difficulty obtaining assistive technology from the Office of Vocational Rehabilitation (OVR), including the Bureau of Vocational Rehabilitation Services (BVRS) and Bureau of Blindness and Visual Services (BBVS). CAP services include information and referral, mediation/negotiation, and assistance with appeals. To contact them directly call 1-888-745-2357 or visit their website for more information.
- Pennsylvania’s Initiative on Assistive Technology (PIAT) provides information and assistance to people with disabilities and their families to work through health insurances, public programs, recycling programs, non-governmental funding to determine which resource might help. Information and assistance is provided via telephone or email through the central office. Individuals can make an appointment for in-person assistance by contacting their local Assistive Technology Resource Center (ATRC). To contact them directly call 1-800-204-PIAT; 215-204-1356 (TTY) or visit their website for more information.
Cost Effectiveness Considerations
It is important to consider cost effectiveness of a funding request. Individuals should consider the “appropriateness of the full range of AAC approaches”. This includes devices with varying features (e.g., words vs. photographs) and complexity (e.g., static vs. dynamic display), as well as strategies that do not involve using external aids or expensive equipment. Team members will need to collaborate to promote cost effectiveness and identify AAC devices and strategies that work best for the individual. Funding speech generating devices (SGDs) can be cost effective by including system trials to test and identify AAC that is most helpful, as well as services under the direction of a qualified professional (during and after the acquisition of the device).
What Do I Need To Get a Device Funded?
Most device and equipment manufacturers have funding departments that can help you piece together a funding package that the company uses to get funding for a device. In general, the following components are required:
- A speech-generating device (SGD) funding report
- This documents the consumer’s skills and areas of need
- It should be a full evaluation (including information about vision, hearing, physical status, language, and cognition)
- For details about required components of the report, see our Funding Information (for SLPS) page.
- It must be written by a licensed speech-language pathologist (required by insurance, medicaid, etc.)
- A prescription from a physician
- Needs to specifically identify: device and any additional equipment needed (e.g. mount, keyguard, carrying case, etc.)
- Physician’s information must also be included (NPI #, license #, UPIN #, medicaid provider #)
- May also need a “Letter of Medical Necessity” from the physician (including the consumer’s relevant medical diagnosis, communication diagnosis, prognosis and length of need)
- Paperwork for the specific company (may include a release of information, client information form, etc.)
7 Steps of Funding Augmentative and Alternative Communication or Speech-Generating Devices (AAC/SGD)
Most SGDs (Speech Generating Devices) are covered by Medicare/Medicaid and most private health insurers and health plans. Once you have determined a device, the manufacturer’s or third-party vendor’s funding team will work with you to simplify the process.
Step 1: Consult your physician
A physician’s face-to-face visit for patients that need any type of Durable Medical Equipment (including AAC/SGD’s) is required. The CMS regulation states that a face-to-face visit by a physician (MD or DO) must have occurred no greater than six (6) months prior to the written order for equipment. Several Device Manufacturers have a form that can be completed that your physician can sign.
Step 2: Consult an SLP
Your Speech-Language Pathologist (SLP) will conduct an AAC/SGD evaluation to determine your communication needs. Your SLP will determine what type of device is most appropriate for you. Once these needs are established and a device has been selected, the SLP will complete the AAC/SGD report.
Step 3: Choose your device
There is a variety of speech generating devices to choose from. Your physician and Speech-Language Pathologist will help you choose the device that best suits your needs based on individual abilities and preferences.
Step 4: Complete the funding packet
The funding packet typically consists of a Client Information Form, Assignment of Benefits Form, Speech-Language Pathologist Evaluation, Physician’s Documentation of a Face to Face Visit, Physician’s Prescription and copies (front and back) of your insurance card(s). Addition documentation may be required for your specific insurer.
Step 5: Submit the funding packet to the manufacturer’s/vendor’s funding department
Once the funding packet is received by the funding coordinator, he/she will review the packet to ensure that it Funding AAC in the Schoolsmeets the criteria for submission by the client’s specific insurer. Then they will submit the packet to the insurance provider(s).
Step 6: The funding experts do the rest!
Once the funding packet has been submitted to the insurance agency(ies), the next steps are dependent on the insurance carrier. Most insurers follow a similar process in reviewing funding applications prior to authorizing. See this video for a description of what happens while the funding coordinator does the rest.
Step 7: The device is shipped!!
The insurance agency will notify you of the approval of the device. Usually this is in the form of a letter. When notified of approval, the funding coordinator will proceed with the order and the equipment will be delivered to the client’s address.
Praactical AAC post on funding in the schools!
Video of the Week: Who Can Pay for AAC Devices for Public School Students by Lew Golinker
Insurance Coverage and iPads for Communication
Over the past few years, companies, such as ACCI and FRS, have created iPad-based, “bundled”, communication devices. These devices include a sturdy case and additional amplification. Bundling these features together means that it is now possible to request insurance coverage. These are considered dedicated communication devices. In insurance speak, this means that you can’t surf the web or play Angry Birds. The iPads are ‘dedicated’ to communication, and will thus be considered “durable medical equipment.” The following devices are currently on the market.
- The TouchChat Express from Saltillo
- The Choice Communicator from ACCI
- The Prio from PRC
- The Quicktalker from Ablenet
- The Proslate 10 from FRS
Most companies provide funding assistance. Once your client is evaluated and the technology has been deemed appropriate, they will help you submit your claim to insurance, including Medicaid, Medicare, and private coverage. The report must be written by a speech-language pathologist.
0 comments on “Funding for Users & Families”