Insurance Tips

Maneuvering through an insurance policy to obtain funding for a Speech Generating Device (SGD) can be a challenge. PRC has experience working with insurance companies across the nation.

Here are some helpful tips:

• Have the insurance card in front of you and be prepared to supply them with the following information:
  • Policyholder's name and identification number
  • Group number
  • Client's name, date of birth, diagnosis
• Ask if the procedure/HCPCS code is covered benefit
  • Here is a list of Procedure/HCPCS codes for a PRC SGD
    • E2508: Accent 700-SB
    • E2510: Accent 700, Accent 1000, Accent 1200, ECO 2
    • E2511: Additional Software
    • E2512: Mounting System
    • E2599: Accessories (ex: carry case, access method, keyguard, etc.)
• Ask for in-network and out-of-network benefits
  • The deductible and co-pay may be different if PRC is an in-network or out-of-network provider with the insurance company. If PRC is out-of-network, we may be able to negotiate a single case agreement with the insurance company for in-network benefits. Payment for co-pay and/or deductible will need to be secured prior to shipping equipment.
• Ask if a physician's referral is required
  • Usually, your primary care physician will need to refer the client to PRC for the SGD.

With this information the insurance company should be able to verify the policyholder's benefits.

Once the proper clinicals are received by the Funding Department, we will work directly with the insurance company to begin the medical review process.

The Funding Department cannot submit a claim to your insurance company until payment is secured and the SGD is shipped.