Funding Services

Funding Package Checklist

Required Funding Documents                       

Forms: (Certificate of Medical Necessity (CMN), Client Information & Assignment of Benefits Form) to be completed and returned to ACCI.  Augmentative Communication Consultants, Inc.

Supporting Documents                                        

ACCI Funding Terminology

Sample AAC Speech Language Evaluation

Speech Language AAC Evaluations    (Completed by the Speech Language Pathologist before Script is written).                                                                                                          

Tools

Locating a Speech Language Pathologist, Selecting a Speech Language Pathologist

Sample Addendums for Clarification or Support of Device

Addendum to Evaluation Report Denial
Request to Allow Exception for Out of Network Provider Addendum
Discontinued Model Addendum
Client Medical Appeal Addendum
Sample for Proloquo2Go Denial non-participation provider

Sample of Non-Medical Appeals for SGD

Sample Format for Out of Network Provider

Sample Format for Out of Network Provider-Educational Purposes Only 
Sample Format for Sole Manufacturer - Dedicated ACCI Choice
Request to Use Non-Participating Provider
Sample Format for Out of Network Provider 10-19
Sample for Proloquo2Go Denial non-participation provider  

Resources 

Reaching Out to Families (Funding Resources)

"Basic Funding 101" - a short video on the funding process                                              

Copy and paste our email address

to your contact list

  acci1@earthlink.net