I had a similar experience here in NJ with the same piece of equipment; however I was called by the family after they had seen the My Tobii with the vendor but before it was purchased.  Although they said also that they were going to get it no matter what.  I was asked just come to see the client and write the justification.   I explained to them that if I came to do an eval then we would look at all the options available and we would then determine the best AAC system.  They were not really aware of other options I found out as I talked to them. The vendor was also informed of this.   I also tried to explain the funding process and why I could not just write up something.  I think in this case you are right that the family probably got caught up with the immediacy of the need. I can see the vendor wanting to “sell” the system but I know that most of our vendors are aware of the procedures of funding and I would be surprised that the family would not have been told.  However, sometimes families get caught up and indicate that they will buy it no matter what and then the vendor just goes ahead and executes the order on that assumption.  After the family has time to think most do feel that they want to try to get reimbursed.  I agree with you that the rental option is quite positive, and of course your loan equipment service is excellent. M aye we need a 3 day waiting/rescinding  period before ordering like for car, mortgages etc. Perhaps vendors should be required to provide something in writing to the family on the funding process before any final order is executed especially if they say they are going to pay for it out of pocket. I know as part of my assessment funding is discussed at length.  It often takes up a large portion of my after eval work. I have often had families change there minds on how to fund items.  I think one of our problems here is that when people contact the company after seeing the system on the internet or in a magazine they are given the vendor name since I don’t know too many of us that have a My Tobii. So they get referred to the vendor rather than for an assessment. My issue is that with the vendor they only see one type or even make of an item.  Sometimes families think that’s all that’s out there and  they don’t have someone to think them through issues of portability, care, technical service, reliability. The client that I saw actually ended up with a different solution.  I personally have let vendors know that I will work with them but only as part of an assessment looking at all options.

 

Travis M. Tallman CCC-SLP:ATP

Director of Augmentative and Computer Services

xxxxxx@xxxxxxxxx

Lakeview/Cerebral Palsy Association of Middlesex County

732-549-5580 x170

732-494-6235  Fax


From: xxxxxx@xxxxxxxxxxxxxxxxxxxx [mailto:xxxxxx@xxxxxxxxxxxxxxxxxxxx] On Behalf Of Alisa Brownlee
Sent: Monday, December 10, 2007 4:06 PM
To: xxxxxx@xxxxxxxxxxxxxxxxxxxx
Subject: [Assistive Technology] aac funding question

 

A question for the AAC specialists of the group....

 

We have a patient in NJ that paid out of pocket (and without an SLP evaluation) for a My Tobii System from a local vendor.  Now, the family wants to apply to Medicare for partial reimbursement. (the 80% that Medicare would pay for this device)  The vendor is now asking one of the SLP's that work with my Chapter to perform an AAC assessment based on this system then submit the claim to Medicare.  Has anyone on this list had this type of request?  Can a beneficiary request reimbursement for Medicare after the fact?? (the patient has had the device for a few months)

 

I asked Lew Golinker for advice (he is an attorney with the AT Law Center) and he states the process of getting an eval, then script, then submission of device has not been followed.  However, I am wondering if anyone else have faced this problem?  I can't believe this is an isolated incident and I was curious if anyone has any input to this or a similar situation?  (or has someone successfully done this type of "back ordering" before?)

 

Thanks

Alisa

 

 

 

Alisa Brownlee, ATP
Assistive Technology Specialist
ALS (Lou Gehrig's Disease) Association, Greater Philadelphia Chapter

 

Assistive Technology Consultant, ALS Association, National Office


Direct Phone Number: 215-631-1877


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Alisa Brownlee, ATP
Assistive Technology Specialist
ALS (Lou Gehrig's Disease) Association, Greater Philadelphia Chapter

 

Assistive Technology Consultant, ALS Association, National Office


Direct Phone Number: 215-631-1877

 


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