| FUNDING DIRECTORY |
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| Documentation Requirements & Forms | |||||
| Where do I begin? | |||||
| Medicare criteria for Speech Generating Devices | |||||
| Where to send completed forms | |||||
| Locate your ZYGO equipment health plan provider in your state | |||||
| Rental Program Information | |||||
| Funding FAQ | |||||
| Glossary of terms | |||||
| AAC and Funding Resources | |||||
| ZYGO AAC Devices and HCPCS Allowables | |||||
| CLAIMS REQUIREMENTS |
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| Client Profile / Client Information Form | |||||
| Copy of all insurance cards (front and back) |
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| Assignment of Benefits | |||||
| Co-pay and deductible if there is no secondary insurance |
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| Consent Form | |||||
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Speech Therapist's Comprehensive evaluation (dated prior to date of Rx) |
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| Physician’s Prescription | |||||
| Samples: |
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| Sample Speech Therapists Evaluation | |||||
| AAC-RERC Sample Evaluations | |||||
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WHERE DO I BEGIN? If you are just beginning to consider speech generating devices, the process begins with a comprehensive evaluation from a licensed speech language pathologist. You may get help finding an SLP in your area from the American Speech Language Hearing Association (ASHA), your state Speech Language Hearing Association, or from local ZYGO representatives and dealers who can offer names and phone numbers of speech language pathologists they have worked with in the past. |
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