Writing a Letter of Medical Necessity for Accessories, Replacement, or Repairs
So, you just realized that you forgot to consider an accessory when ordering a speech generating device? Or your student has lost or broken something on it? Wow…that NEVER happens…right?!
Yep, it happens and now you have got to figure out how to buy it, replace it, or repair it but don’t know where to start. Here is a handy guide to the general process. Tasks may be slightly different depending upon the individual’s insurance requirements, but it’s all very similar. If you are ordering a new (or additional) mounting system, that would require a Rx and a letter from you (the SLP) stating the reasons why, but for general general purchases such as replacement of batteries or charging units, or repairs for things like broken handle, charging port, speakers, or screens, it’s a pretty simple process. I’ve written it out here and you can also print the LMN sequence for later reference
STEP 1. Identify the specifics of the new, missing, or broken accessory you need
Do you need replacement or repair? Is this an ‘extra’ item that you just decided the child needs?
Find the item on the manufacturer’s website to get the model number or call the funding department to ask for help if not sure. *NOTE: You’ll need the serial number from the device to identify the right items.
STEP 2. Call the funding department for the device manufacturer
You will need to open a case and let them know what you are requesting and then follow the steps below to get the LMN sent to the doctor and returned to them. They will take it from there and get back with you if they need additional information.
STEP 2. Contact the parent
Let him/her know you are addressing this need and will be purchasing through the child's insurance; obtain permission to pursue.
Ask for a front and back copy of the insurance card
Get the name and phone number of the child's primary doctor
STEP 3. Call the MD Office
The MD will have an office manager or RN who handles things like this. Ask for that person, explain what you need, and get an email for sending in these kinds of requests.
STEP 4. Write up the letter of Medical Necessity (LMN)
Use the attached LMN sample letter as a general body for your request. Be sure to fill in the specific details on the letter as outlined.
STEP 5. Email the LMN to the doctor’s office *use this email body to let them know that the info you are sending MUST be copied onto their office letterhead before they sign and fax it:
Dear Dr. _______________
I am the SLP addressing the communication needs of one of your young patients, ___name__.
The student uses a ___name of device__ to communicate and the ___needed item ___ has broken, rendering it unusable. The treating SLP has requested a replacement to allow continued access. As this accessory is an allowable item under insurance coverage, we need this Letter of Medical Necessity copied onto your office letterhead, signed, and faxed directly to manufacturer’s funding department at ___funding office fax #__..
SLP signature
