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Healthcare

Medicare, Managed Care and AAC Devices

Funding Augmentative and Alternative Communication (AAC) Devices Through Medicare

The Decision Making and Appeals Process for HMO and Other Medicare+Choice Participants

This booklet describes the managed care program. It provides answers to the most common questions a Medicare beneficiary, family member, service provider or advocate may have regarding the Medicare decision making and appeals steps that apply to AAC device payment claims:

• What documentation or proof has to be submitted?
• Where should information be sent and who reviews it?
• How is the review conducted (on the record; by telephone; in person)?
• How long will the review take to decide?
• Can I win at this at this decision making or appeal level?
• What do I do next and how long do I have to do it?
• What help is available?
• What can I do if the process does not follow the outline provided here?

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