We ALWAYS tell people that they cannot expect to be
reimbursed after the fact - so if they need a device while
waiting for Medicare, they should arrange to rent or
borrow...but don't buy right away!

I have never known of a successful story where the "process"
(as described by Lew) has not been followed.

"Back ordering" might be construed as fraudulent...(I'm not
a lawyer but it seems to me...)

Amy

---- Original message ----
>Date: Mon, 10 Dec 2007 13:06:06 -0800 (PST)
>From: Alisa Brownlee <xxxxxx@xxxxxxxxx>
>Subject: [Assistive Technology] aac funding question
>To: xxxxxx@xxxxxxxxxxxxxxxxxxxx
>
>     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
>
>     ------------------------------------------------
>
>     Never miss a thing. Make Yahoo your homepage.
>
>   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
>
>
>
>     ------------------------------------------------
>
>   Be a better friend, newshound, and know-it-all with
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Amy S. Goldman, Associate Director
Institute on Disabilities
Temple University

CELEBRATING 10 YEARS OF PA'S ASSISTIVE TECHNOLOGY LENDING LIBRARY!

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