By now, according to the type of insurance coverage the you have, you have identified the corresponding provider in your state. To be eligible to receive equipment through your insurance, your provider must receive these items prior to delivering equipment to the client. This applies to purchases, rentals and repairs (must provide month and year of purchase.)

• Completed Client Profile
• Copy of all insurance cards (front and back)
• Speech Therapist's Comprehensive evaluation (must be dated prior to date of delivery)
• Physician's prescription (must be dated prior to date of delivery), must include doctor's UPIN, diagnosis, length of need and an itemized list of equipment
• Assignment of Benefits, signed by client (not required for Medicaid)
• Consent Form, signed by client
• Co-pay and deductible if there is no secondary insurance

Those documents are to be sent to your provider, who then sends them to the health plan along with pricing and product information. If approved, your provider provides the device and bills the health plan. If denied, the client can appeal to the health plan for reconsideration of the decision.

Additional Resources

The following addresses and telephone numbers are provided so that you will know where to obtain the information/materials you need or where to send inquiries.

Durable Medical Equipment Regional Carriers (DMERCs)

Region A Connecticut, Delaware, Main, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont HealthNow New York, Inc. PO Box 6800 Wilkes-Barre, PA 18773-6800 Phone: 866-419-9458 Website: www.umd.nycpic.com

Region B District of Columbia, Illinois, Indiana, Maryland, Michigan, Minnesota, Ohio, West Virginia, Wisconsin, Virginia AdminaStar Federal, Inc. PO Box 7078 Indianapolis, IN 46207-7078 Phone: 877-299-7900 Website: www.adminastar.com

Region C Alabama, Arkansas, Colorado, Florida, Georgia, Kentucky, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, Puerto Rico, South Carolina, Tennessee, Texas, virgin Islands Palmetto Government Benefits Administrators Medicare DMERC Operations PO Box 100141 Columbia, SC 29202-3141 Phone: 866-238-9650 Website: www.palmettogba.com

Region D Alaska, American Samoa, Arizona, California, Guam, Hawaii, Idaho, Iowa, Kansas, Mariana Islands, Missouri, Montana, Nebraska, Nevada, North Dakota, Oregon, South Dakota, Utah, Washington, Wyoming CIGNA HealthCare Medicare Administration PO Box 690 Nashville, TN 37202 Phone: 877-320-0390 Website: www.cignamedicare.com