Checklist - Matching User to AT



Checklist – Matching User to AT: Policies, Procedures & Workflow


ü      Medical referrals, when required, by whom


ü      Training for staff who perform matching: define need, identify source


ü      Document alternative products, sources for users


ü      Document assessment procedures for each device


ü      Develop waiver of liability


ü      Identify level of technical assistance needed for each device, source


ü      Develop workflow for device matching




Suggested Documentation




Referrals, when required,  who can refer

How referral for device will be obtained, documentation

When medical prescription is required

Document which medical specialties are required to prescribe each device (Medicare rules)

Where referrals, prescriptions are filed in user records

How to handle referrals

How to handle prescriptions

How to obtain certificate of medical necessity if required (may be relevant if fees are charged, or dealing with Medicare)

Matching users to appropriate devices

User assessment process for device needed


Prepare step-by-step workflow for matching device to user for each device

Liability for matching devices to user, waiver of

How to communicate and get user confirmation of waiver

Process for disclosure and getting user confirmation for the record

Technical assistance provided (or not) for each device

Define who will provide technical assistance, when

Document user training process for each device

Documents for tracking

Step-by-step instructions for use of each device

Process for tracking TA provided to new users




This work is supported under a five-year cooperative agreement # H235V060016 awarded by the U.S. Department of Education, Office of Special Education and Rehabilitative Services, and is administered by the Pass It On Center of the Georgia Department of Labor – Tools for Life.  However, the contents of this publication do not necessarily represent the policy or opinions of the Department of Education, or the Georgia Department of Labor, and you should not assume endorsements of this document by the Federal government or the Georgia Department of Labor.



















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Other Information

Title: Checklist - Matching User to AT
Module: User Services
Author: Trish Redmon
Audience: Implementer
Sub Title: Policies and Procedures
Organization Source: Pass It On Center
Last Reviewed: 10-25-2009 6:52 PM