Finding the Right Insurance Provider
There are many different insurance providers who all offer different levels of coverage. These are also different from plans that may be offered through your employer or state-specific Medicaid.
We can help you find the best source of funding. To begin making inquiries, we need to get an accurate estimate of your financial responsibility to purchase a device.
Potential Sources of Funding
Step-by-Step Funding Request Process
Fill out authorization forms
Please complete and return the following documents to LC Technologies for specific plan benefits.
Click on each document to the right to open it in a new window.
Complete the financial responsibility form
Please complete and return this form to our office via fax: (703) 385-7137
Submit medical forms
Regardless of which insurance provider you have, you will need to submit the following documents. Complete and forward them to LC Technologies.
• SLP Report
A communication evaluation by a speech-langauge pathologist needs to document the need for a communication device. This evaluation must be done less than 6 months after a patient’s face-to-face visit with a physician and the evaluation must pre-date the physicians DME prescription form.
• Physican Prescription
Physicians must provide a DME (durable medical eqipment) prescription along with clinical notes from the patient’s most recent face-to-face visit.
Note: In some instances, insurance companies require a Prior Authorization before the purchase of a Speech Generating Device, and these medical documents will need to be forwarded to the clinical department as well.
Include a copy of your insurance card
Please make a clear copy of your insurance card both front and back and include with your submitted documents.
Insurance card (front and back)
Retain for your records
Keep these documents on hand for your records.
- Privacy Practices
- DMEPOS Standards
Submit Required Documents
Send all completed paperwork to LC Technologies via fax or mail.
LC Technologies, Inc.
10363 Democracy Lane
Fairfax, VA 22030