How to Obtain Funding

PRC offers several augmentative communication devices designed to ensure successful communication to a wide range of people with specific needs. An assessment by a speech language pathologist will help determine the device that is the best fit. Third party payers such as Medicare, Medicaid, and health insurance maintain certain requirements that must be met before they will approve funding or payment for a device.

Follow these steps to help you prepare for a successful funding outcome:

1. Make an appointment with a licensed speech language pathologist knowledgeable in AAC or Speech Generating Devices (Speech Language Pathologist Locator). Focusing on the person's needs and diagnosis, they will help determine the most appropriate device characteristics and language system that meet your family members long-term needs.
2. Contact your local PRC representative. Your PRC representative will be able to demonstrate our equipment and help you and your speech language pathologist determine what language system approach and device and accessories will best meet your communication needs. Your representative will provide valuable assistance to you and your speech pathologist during this stage of the process. The outcome is that the speech language pathologist needs to write a complete evaluation report to establish medical necessity for the equipment. This written evaluation report needs to be included in the funding request submitted to PRC.
3. Determine the individual's eligible paying source(s). This may include Medicare, Medicaid, or health insurance. PRC is a provider with most state Medicaid programs. We also are a Medicare provider and work with private insurance companies. It is important that you disclose all potential paying sources to your speech pathologist so he/she can provide PRC with the proper state specific documentation that is required.
4. Together with the speech language pathologist, you will compile documentation that makes up a Funding Submission Packet. Items included in the packet are: the Speech Language Evaluation; copies (front and back) of Medicare, Medicaid, or Insurance cards; state-specific forms; and other items listed in the Funding Assistant web tool. The packet may be either faxed or mailed to the PRC Funding Department. Our Funding Specialists will work with the third party payer(s) to submit the proper documentation and receive an authorization for payment.
5. The PRC Funding Department works with all parties to make sure all documentation required is complete before submitting. We will submit the funding request and will be there to guide the process every step of the way. Once an authorization is issued from the third party payer(s), PRC will arrange to deliver the equipment and your local PRC representative will arrange training so that the new device owner can begin to communicate effectively. The PRC Funding Department will then submit the claim for billing to Medicare, Medicaid, and Insurance payer(s).