CHOOSING THE RIGHT EQUIPMENT FOR COMMUNICATION
The initial evaluation is very important in determining what kind of equipment to choose. It should be done by a physician, physical or occupational therapist, or a local medical center, who may consult with vendors (equipment supply stores) to find the right piece of equipment. It is good to do your own research. Call or compose a letter requesting catalogs from a variety of rehabilitation equipment vendors and talk to other families. Some vendors will bring the equipment to your home or will allow you to keep it on a short trial basis.
Contact your insurance company and thoroughly review your policy. Follow any required procedures to the letter. Any deviation could result in a reduction of benets. You may need pre–approval. After you purchase the equipment, it may be too late. If you need a prescription for the equipment, get the forms you need from the insurance company and take them to your physician to complete. After an evaluation, the physician will write a prescription along with a letter of justication.
You should start early, especially for large or custom items. It may take 4 to 6 months to get a new wheelchair. If your request is denied, follow up with an appeal. You may have to make some phone calls, get more documentation, or even get a second medical opinion; but the extra work often pays o.
TIP! When speaking with insurance companies, use the term
“Speech Generating Device.”
Successful Medical Necessity Letters
Here are two successful letters from Doctors that were used to obtain devices. You are free to use these to your advantage. Send them to your caseworkers, doctors, and therapists to assist them in what is needed to write a successful letter.
To Whom It May Concern:
______ is a five year old girl with Rett Syndrome. Rett Syndrome is the only pervasive developmental disorder with a known genetic cause. It is a neurodevelopmental disorder and one of the most common causes of severe impairment in females. (MECP2), which is located on ……..
Additional Funding Sources
There are a number of funding sources for devices and services and it is important to go through them in proper order. First, try insurance or Medicaid, schools or the Vocational Rehabilitation Agency. Each source has its own procedures and policies, so do your homework.
Schools may purchase communication devices to enable the student to participate in a normal academic setting.
INSURANCE / MEDICAID
A claim of medical necessity is a must. Denial is not the end of the story. Make it clear you will appeal. Download the PDF for a Medicaid Funding Article.
These programs may fund equipment if it is the main obstacle to employment. Eligibility vary from state to state.
Businesses can take a tax write–o for charitable contributions and get good community PR at the same time.
Check with trust division of banks in your area to see if a trust fund exists for the purpose of helping people with disabilities.
Local civic organizations such as the Lions Clubs, Kiwanis and Rotary often contribute to the purchase of equipment.
Churches and other organizations are often helpful in putting on a fundraiser, such as a car wash, bake sale, dinner or rae.
These organizations grant wishes to people with specific needs. Contact the Sunshine Foundation or the Make a Wish Foundation.