Some insurance companies require a face-to-face visit with your healthcare provider prior to covering the cost of Durable Medical Equipment, including Speech Generating Devices (SGDs). We’ve answered some of the frequently asked questions below. If you have any questions or would like to talk with someone about this insurance requirement, please contact us at 877-392-2299, Option 2, or email firstname.lastname@example.org.
Face-To-Face Physician's Visit FAQs
What is a Face-to-Face Physician's Visit?
Insurance requires someone seeking a Speech Generating Device (SGD) to visit with their doctor, in-person or via Telehealth, to discuss the need for the SGD. As the provider of the SGD, we need copies of those visit notes faxed to us so we can submit them to insurance. See the Helpful Hints document for details about what needs to be included within the doctor’s documentation.
Is this requirement specific to SGDs?
No, it is required when seeking other DME items, including oxygen, wheelchairs, hospital beds, and more.
How soon does this visit need to happen?
We are not able to pursue funding for the SGD through your insurance until we have the visit notes and we’ve reviewed them to confirm they meet insurance requirements.
Does the visit need to be with an M.D.?
No. The visit can be with a general practitioner, MD, DO, neurologist, PA, NP, etc.
I just saw the doctor, do I have to schedule another appointment?
Not necessarily. If you spoke with the doctor about the topics mentioned in our Helpful Hints document and the physician’s documentation includes each requirement, those visit notes may be all we need. If the documentation doesn’t include each of the Helpful Hints items, a new visit will be needed. Please ask your physician’s office to fax us the visit notes at 888-310-3112 and we will confirm what’s needed to proceed.
I've scheduled or completed the appointment, now what?
Let us know when the appointment will take place (or took place) and the physician that will be seen (or was seen). This will enable us to reach out to the physician’s office requesting a copy of the visit notes once the visit is completed. You can reach us at 877-392-2299, Option 2, or at email@example.com.
Should I take anything with me to the appointment?
Yes, please take the Helpful Hints document and give it to your physician. It is a reference sheet that will assist the physician with meeting the insurance’s documentation requirements.
What happens after the appointment has been completed?
The physician should fax us the visit notes to 888-310-3112. It must be the visit notes, which are part of the medical record. A letter or any other documentation from the physician will not meet insurance requirements.
What happens if the notes from the visit don't meet insurance requirements?
Our team will work with the physician’s office to secure the necessary requirements, such as a missing signature, a date, etc. If the visit notes do not contain the information specified by insurance, another visit will be needed. It is very important you take the Helpful Hints with you to the appointment and ask your physician to refer to it when completing their documentation.