SoonerCare – Provider for Speech-Generating Devices

Oklahoma ABLE Tech collaborates with the Oklahoma Health Care Authority (OHCA) as durable medical equipment (DME) provider of vending iPads, apps, and durable cases as speech-generating devices (SGD) to eligible members.

The following requirements are needed to request ANY speech-generating device from SoonerCare - including those from Apple (iPad and app), Prentke Romich Company (PRC), Tobii Dynavox, and Saltillo, etc.

Requirements include:

AAC Evaluation conducted by a licensed SLP (completed within the last 6 months). Please include the SLP’s phone number and email address. Link to OHCA Guidelines for Evaluation for Speech Generating Device
Video documentation demonstrating functional use (preferably on a flash drive that won't be returned). The entire video should be no more than 5-8 minutes. Video media needs to be submitted in a format that is compatible with viewing in Windows Media Player.
Signed and dated order, referral, or prescription stating device name, communication app if an iPad, and specific accessories (straps, key-guards, cases, tempered glass screen protector, etc.) written by an OHCA-contracted qualified medical professional (MD, DO, CNP, APRN). The order must be signed within 90 days of the evaluation.
Letter of medical necessity if the statement of medical necessity is not in the prescription (See below a sample of a separate letter of medical necessity; may be included on the prescription).
Copy of most recent visit with the doctor where expressive communication disorder (examples include but not limited to absence of natural speech, extremely limited natural speech, treatment history reflecting little to no progress acquiring functional speech, progressive or degenerative disease or condition which will result in deterioration or loss of speech, or illness or injury resulting in loss of existing speech) is noted (visit on notes must be within a calendar year of the authorization request).
Release of Liability form signed by the parent/guardian (downloadable form below).
Copy of private insurance card, front and back MUST be provided at the time the packet is sent if the individual has private insurance and SoonerCare.

The Fine Print - What You Need to Know

SoonerCare approves devices for persons up to age 21.
The evaluation must include trials for a minimum of three different language systems (LAMP WFL, Proloquo2Go, Core First on TD Snap, WordPower108 SS on TouchChat HD with WordPower, etc.)
The request MUST be submitted by a licensed speech pathologist to Oklahoma ABLE Tech.
- Approved requests will Include the following:
  - A New iPad purchased from OrangeTech
    - iPad 9th generation, 10.2-inch screen, 64 GB, and any color for $309.00
    - If a different iPad model than above is requested, the exact iPad model (iPad Pro 12.9-inch 6^th generation, iPad Pro 11-inch 4^th generation, iPad Mini 6^th generation, iPad 10.9-inch 10^th generation, etc.) needs to be documented on the doctor’s prescription, letter of medical necessity, and in the speech-language pathologist’s report document the justification to why this iPad is requested (size portability, etc.)
      - Ensure the iPad model documented is the same model on all documentation
  - The appropriate communication application
  - A durable case (Ex. SEYMAC, ZenRich, Otterbox, etc.)
    - Ensure the case requested has the features recommended for the individual (shoulder strap, handle, screen protector, kickstand, etc.)
    - Ensure the iPad case requested is for the same model of iPad requested
    - If an iPad case with features such as built-in speakers is requested, ensure the case is named on the doctor’s prescription, letter of medical necessity, and in the speech-language pathologist’s report document the justification as to why the features on the case are requested
  - The following items can be requested and provided. They NEED to be documented on the doctor’s prescription, letter of medical necessity, and in the speech-language pathologist’s report document the justification as to why they are requested
    - Tempered-glass screen protector
    - Keyguard
      - Keyguards can be ordered from the following:
        
        Keyguard Assist
        
        Multiple grid sizes are available for multiple communication apps and iPad cases.
        
        Based on recommendations from Keyguard Assist to make the keyguard durable, some settings need to be changed within the app. These changes may decrease the size of the buttons within the communication app.
        
        A case from their provided list will need to be requested
        
        The SEYMAC case for the 10.2-inch 9^th generation iPad with a keyguard has been previously requested and works well.
        
        Adapted Creations on Esty
        
        A few grid size options are available for a few communication apps and iPad cases.
        
        Settings do not need to be changed within the app allowing the buttons to remain their typical size
        
        A case from their provided listings will need to be requested
        
        The SEYMAC case for the 10.2-inch 9^th generation iPad with a keyguard has been previously requested and works well.
        
        A screen protector that is built-into the iPad case will not work in conjunction with a keyguard. If a screen proctor is recommended, request a Tempered-glass screen protector. It NEEDS to be documented on the doctor’s prescription, letter of medical necessity, and in the speech-language pathologist’s report document the justification as to why it is requested
CPT/HCPCS Code for the iPad, app, and case is E2599 - Accessory for Speech-Generating Device, Not Otherwise Classified
SoonerCare is a payor of last resort. If the SoonerCare member has insurance coverage from more than one entity, the other entity(s) must be billed first for the SGD. An Explanation of Benefits (EOB) letter must be presented to SoonerCare before they will pay the balance total for the SGD.

Need Assistance with Report Writing?

For assistance in writing the report and to access the forms needed, please visit AAC Funding (Your PRC and Saltillo Funding Source). This resource is designed to help people with requests for PRC and Saltillo equipment; however, the final report can be customized for any speech-generating device.

How to Submit Your Request

Once all required documentation has been collected, please submit your requests for iPads, apps, and durable cases as speech-generating devices via USPS, UPS, FedEx, etc., to:

Email – Terri Harris at terri.m.harris@okstate.edu or Stephanie Hesser at stephanie.hesser@okstate.edu

Address - Oklahoma ABLE Tech
1514 W. Hall of Fame
Stillwater, OK 74078

Toll-free: 800.257.1705
405.744.2487 (fax)