AAC for Speech-Language Pathologists

Support for Insurance Reports

Writing a new insurance report can feel like starting off on a trek across the desert with no water. It may feel hard to take that first step. However, there are resources that can help you make the journey.

First off, don’t forget that the device vendors are there to help. They want you to succeed and will help make sure your report is well crafted. Most vendors have funding specialists and online resources.  Here are the funding links and numbers for some of the major companies:

• • Forbes AAC: https://www.forbesaac.com/funding
    • Print out their funding forms or speak to a representative
  • Tobii Dynavox: https://us.tobiidynavox.com/pages/funding 
    • You can create and submit your report online through their E-funding portal
  • PRC Saltillo: https://www.prentrom.com/funding
    • Take their Funding Toolkit tour and submit reports online
  • Saltillo: https://saltillo.com/funding
    • Getting a NovaChat? While PRC and Saltillo have merged, they still maintain their website. It will take you to some of their joint resources.
  • AbleNet: https://www.ablenetinc.com
    • Call their funding department for support.
    • AbleNet has a new insurance report template for clinicians: https://quicktalkerfreestyle.com/speech-evaluation-video-form/
  • ACCI: https://www.acciinc.com
    • ACCI has some funding resources on their website and a price point below most of their competitors for iPad-based communication systems
  • Lingraphica: https://www.aphasia.com/aac-device-funding-options/
    • They produce devices for people with aphasia
  • Eyegaze Inc.: https://eyegaze.com/funding/
    • Funding documents and support online

It is also possible to get coverage for tablet-based AAC apps. To obtain these through insurance, you will go through a vendor (such as those above) that sells “bundled iPads”. They lock down the device for communication, so that it will be covered by insurance.

Fair warning, when you write an insurance report for a bundled device, you will NOT want to call it an iPad. You are requesting funding for a dedicated communication device. You might call it a “tablet-based, dynamic display communication device.” Call it an iPad and your report is likely to be rejected. Insurance does not like to cover “consumer electronics.”

That is why vendors need to lock devices down to ensure they are used only for face to face communication. Many AAC users do need to surf the web, run businesses, send emails, and text their friends. There is a back door. Talk to the device vendor about paying the fee to have the communication device “unlocked” after it is approved. 

Another tip: The funding process is all about demonstrating Medical Necessity. You are going to need an overview of the client’s medical history. Past medical problems, such as a seizure disorder, may be used to help justify the necessity of the device. 

Your language should be direct and firm. Wishy washy phrases like, “he might have a seizure”, or “sometimes he is hard to understand” will not get you what you need. You are better off with a strong, affirmative statement, such as, “client X must be given access to a robust AAC system in order to communicate his urgent medical needs.”

Don’t worry if you get your first rejection. It happens to everyone. Just remember that you likely have only 30 days to appeal and provide more supporting evidence. Don’t give up! In Pennsylvania, if your client has Medicaid funding, the waiver may be able to pay for the device if insurance says no.

Additional Resources

• PraacticalAAC: https://praacticalaac.org/tag/insurance/
• The Rehabilitation Engineering Research Center at Penn State: https://aac-rerc.psu.edu/index.php/pages/show/id/23
  • Medicare funding resources
• The Delaware Assistive Technology Initiative: http://www.dati.org/funding/lmnsampleALL.htm
  • Sample letters of medical necessity
• The AAC Institute: https://aacinstitute.org/wp-content/uploads/2014/12/SGD-Funding-request-and-medical-necessity.pdf
  • General overview of the funding process

For more information on writing your report, check out the Writing an Insurance Request article.

You can also reach out to TechOWLpa.org with further questions, or check out the AT3Center.org to find your state’s AT Act Program.