Roles and Responsibilities

SLP

• SLP guides the trial and provides training at time of equipment set up.
• SLP responsible (with parent/caregiver support) for helping to procure all the necessary documentation for submitting to insurance for purchase of equipment if that is pursued. See aacfunding.com for more information on what funding paperwork is required in each state.

Parent/Caregiver

• The responsible party to the agreement (client or parent/caregiver) provides PRC-Saltillo with insurance information (or credit card), signed trial device agreement and client Information/equipment selection form.
• Comply with the terms and conditions below.
• Return the trial device at the time it is due


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PRC-Saltillo

• PRC-Saltillo provides client with a trial device and works with your insurance company to verify benefits and submit need paperwork for coverage if purchase is pursued.
• Following trial, if purchased device is approved, PRC-Saltillo sends a box with new device that can be used to return the trialed device.
• PRC-Saltillo will assist as needed with transfer of information from trialed device to new device.
• PRC-Saltillo consultants provide set up and training upon request. (www.prentrom.com/education (for PRC products) or www.saltillo.com/training (for Saltillo products).
• PRC-Saltillo provides technical service and support with trialed and purchased equipment.

Terms & Conditions

In order to receive a trial device, this online application must be completed in full.

The initial trial period for loaned equipment is four weeks. If the trial equipment is selected as the appropriate communication solution and the decision to pursue funding is made, the trial period can be extended up to four (4) weeks pending submission of funding paperwork. Once PRC-Saltillo is notified of the decision to pursue purchase of new equipment, all of the necessary funding paperwork must be submitted to PRC-Saltillo as soon as possible and no later than four (4) weeks. PRC-Saltillo cannot submit incomplete funding submissions. If funding paperwork is not submitted at the end of the extended trial period, the trial equipment must be returned. Once all of the necessary funding paperwork is submitted to PRC-Saltillo, so that a complete funding packet can be submitted to the funding source, the trial loan period can be extended until the funding source approves or denies.

Only upon receipt by PRC-Saltillo of funding approval, can new equipment can be shipped. At that point, the trialed equipment must be returned to PRC-Saltillo. If the funding source denies and other payment options are not available, the trialed equipment must be returned. Trialed equipment must be returned at one of the following times:

1. At the end of the four-week trial period if purchase of new equipment is not pursued.
2. If all required funding paperwork is not provided to PRC-Saltillo within four weeks of purchase decision.
3. Upon funding approved and receipt of new device or when funding is denied and no other funding options are available.

If trialed equipment is not returned in accordance with this agreement, the client/parent/caregiver (responsible party) will be liable for late fees. A late fee of $125.00 per week will be charged if all trial equipment is not received by PRC-Saltillo at the agreed upon return date. A minimum charge of $125.00 will be assessed to all late returns. Damage, loss, or theft of the trialed equipment is the responsibility of the responsible party to this agreement.

Optional accessories may be available and must be requested separately. Damage, loss, or theft of a trial device is the responsibility of the person who signs this agreement or of the entity represented by signature on this agreement.

Responsible Party

Client Information

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Your request will be reviewed and you will be contacted by PRC-Saltillo within 3-5 business days.

We look forward to working with you!