
AAC Funding
Preferred Provider Arrangements
Preferred provider arrangments are agreements between insurance companies or other third party funding agents and manufacturers or suppliers of durable medical equipment (DME). AAC devices are classified as DME. The advantage of such arrangements to funding agents is that they can negotiate a lower price for providing AAC devices. The incentive to participate in these arrangements for manufacturers and suppliers is that they may be give an exclusive providership.
The way things work from the consumer and service provider perspective is this. A comprehensive assessment is completed. A recommendation is made for an AAC system (device, language application program, peripherals, etc.) that will result in the highest communication performance and best life experience. The request is made for funding. The funding agent replies with the intention of providing an AAC system other than the one selected in the AAC assessment.
The appropriate response from both the AAC team and the family is to advocate for the selected system. This means that the funding agent must be contacted immediately with the message that the selected system cannot be changed. This may mean following through with an appeal process. However, the funding agent can be directed to components of the comprehensive assessment report that support the selected system. The following points may be helpful:
Point out features that are distinctive with the selected system.- Point out the performance that was achieved during the trial of the selected system.
- Point out the user and family preferences and satisfaction with the selected system.
The experience of AAC teams and families who have challenged preferred provider arrangements has been positive.
Contact AAC Institute (support@aacinstitute.org) if you need help with this process. Do not allow funding agents to override comprehensive AAC assessments and in the process reduce the communication performance and life experience of individuals who use AAC.
AAC Institute Position Statement on Preferred Provider Practices.