Frequently Asked Questions
Getting approval for funding of Assistive Technology through your Virginia Medicaid waivers does require a written Letter of Medical Necessity (LMN). Many therapists do know how to compose the LMN in such a manner to dictate medical necessity.
Use this guide to see what items must be addressed when the professional is writing the LMN.
Who writes your Letter of Medical Necessity (LMN) depends primarily on what the person’s medical needs are and with what they need assistance.
Ability Unlimited does not recommend specific AT devices for any person. We take your doctor’s and therapist’s recommendations, outlined in the written letter of medical necessity as required by DMAS, and submit a request for you to get those items funded through your Virginia Medicaid waiver.
If you or your loved one is on a DD Comprehensive waiver and they are under the age of 21, their AT request will be submitted under EPSDT. If they are over the age of 21, their request for AT will be submitted under their BI/CL/FIS waiver.
All the requests for people on DD waivers are submitted through their Support Coordinator and reviewed by DBHDS staff.
While we may not be able to work with an insurance company for one type of item/service, we may be able to work with them for another type of service.
There are numerous steps involved so we are unable to give an exact estimate. We will do everything we can to make sure the insurance company receives all the necessary documents to make their decision in a timely manner.
Once the item or items are approved by the funding source, our policy is to order them by the following week. You will receive an email with all the order and delivery information available at the time of the order. Some items take a little longer to ship from the vendor and we get shipping updates later. If an item is backordered due to out of stock status, we will update you.
If an item has been denied by another provider due to lack of documented information, we can work with the medical team to gather updated documents to provide the additional information needed to try and gain approval. However, if an item is denied because it is deemed not medically necessary for the person, then that would be the same determination made if resubmitted.
No, there are specifics in the regulations that are excluded from coverage and they give general examples of these items. It is best to focus on the medical necessity of the items you are requesting, as an item can be a medical necessity for one person and not medically necessary for another.
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Waiver Services Representative
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Waiver Services Team Lead
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