What to Gather Before You Apply

Before you start a Katie Beckett (TEFRA) application or renewal in Georgia, gathering the correct documents will save you hours of stress—and greatly reduce the chance of a denial.

This guide shows you exactly what to collect, why it matters, and how each document is used during the review.

🎥 Watch: What to Gather Before You Apply

📌 What You Need to Gather (Quick Overview)

Your Katie Beckett packet includes three major parts:

• Medical & therapy documentation — the core of the approval
• School / behavioral documentation — real-world functional impact
• Parent forms & financial documents — identity, insurance, income

1️⃣ Medical & Therapy Documentation

This section carries the most weight. Reviewers use these records to understand diagnoses, daily challenges, safety needs, and why Medicaid-level care is required. Your role is primarily to request documents, gather evaluations, and help your Primary Care Provider (PCP) fill out the state forms completely.

• Psychological Evaluation (age 6+) or Developmental Evaluation (under 6)
  Must include diagnosis, cognitive/adaptive functioning, and behavioral impact. Required if requesting ICF/ID level of care or if “alert and cooperative” is not selected on line #33 of the DMA-6A. Must be less than 3 years old.
• 90 Days of Therapy Notes
  OT, PT, Speech, and/or ABA. Notes must be dated, signed, and show regular appointments (often interpreted as ~5 sessions/week). If appointments were canceled due to illness, holidays, staffing, or insurance issues, include a short cover letter explaining the lapse.
• 90 Days of Nursing Notes
  Only required for medically complex children or those requesting a Nursing Level of Care.
• 12 Months of Hospital Discharge Summaries
  Required only if your child regularly uses hospital services.
• Diagnosis List
  Create a supplemental document listing all diagnoses from specialists. (You do not need full specialist reports.)
• Medication List
  Include name, dose, and purpose. Add functional side effects only if clinically relevant.
• Primary Care Provider Paperwork
  Your doctor must complete:
  
  
  
  • Medical History
  
  
  • Plan of Care
  
  
  • Medical Order of Necessity
  
  
  • Medication List
  
  
  • KB Forms: DMA-6A, DMA-704, DMA-706
  
  
  
  

  Expect this to take the longest. Provide your PCP with specialty records to help them answer accurately. Double-check that every box is filled in before submitting. (Mine charged $70 per child.)

  
  

2️⃣ School & Behavioral Documentation

We homeschool, so we did not submit school records. If your child attends school, or you homeschool but use school services, add:

• IEP or 504 Plan with goals and accommodations
• 90 days of school-based therapy notes (OT, PT, counseling, speech)
• Educational or psychological evaluations

3️⃣ Parent Forms & Supporting Documents

These confirm identity, financial eligibility, and insurance information.

• Proof of monthly gross earnings (most recent pay stubs)
• Proof of Citizenship/Alien Status (passport, birth certificate, or other documents from the list provided)
• Copy of child’s Social Security Card
• Child’s bank statements (only if applicable)
• Award letters (SSI, disability, child support—note “not applicable” on TOC if none)
• Health Insurance Information Questionnaire (DMA-285)
• Front and back of insurance card
• Medicaid Application
• HIPAA Authorization
• HIPP Form (send directly to HIPP, not inside your KB packet)
• Cover Letter explaining therapy gaps or anything unusual
• Table of Contents — highly recommended for organization and to note checklist items that were not applicable.

💡 Insurance Cost Breakdown (Optional but Helpful)

This is not required by Georgia, but it can help your doctor accurately complete the Cost Effectiveness section of the DMA-706 form. Gather a simple summary of:

• Your private insurance plan type (PPO, HMO, POS, etc.)
• Deductible (individual & family)
• Out-of-pocket max (individual & family)
• Therapy coverage (OT, PT, Speech, ABA — % covered after deductible)
• Specialist visit coverage
• Prescription coverage (copays, tier costs)
• DME coverage (diapers, adaptive equipment, etc.)
• Your child’s average monthly out-of-pocket costs:
  • Therapies (OT/PT/Speech/ABA)
  • Medications
  • Specialist visits
  • Nursing or incontinence supplies
  • Counseling or behavioral therapy

You can optionally include a short summary page with these totals, but it is not required.

🧾 Printable: Full Checklist

• Psychological or developmental evaluation (current, within 3 years)
• 90 days of therapy notes (OT, PT, Speech, ABA)
• 90 days of nursing notes (if applicable)
• 12 months of hospital discharge summaries (if applicable)
• List of diagnoses
• Medication list
• Primary Care Provider documents
• IEP / 504 plan
• 90 days of school-based therapy notes
• Most recent pay stubs
• Proof of citizenship
• Child’s Social Security card
• Health insurance card
• Health Insurance Questionnaire (DMA-285)
• Medicaid application
• HIPAA form
• HIPP form
• Table of contents

⭐ Pro Tips Before You Submit

• Keep digital copies of everything for renewals and appeals.
• Be specific and clinical—reviewers only know what you write.
• Use therapy language when appropriate (eloping, impulsivity, severe dysregulation).
• Give clear examples (“needs help dressing due to sensory overwhelm and safety concerns”).

Next Step

Or return to the Katie Beckett Georgia Parent Guide.