FEE FOR SERVICE
Payment is due at the end of each therapy session. Cash, check, and credit card are accepted forms of payment. We do not bill your insurance. We are strictly a service provider. By providing your child with an evaluation or treatment, we do not imply or suggest any benefits or reimbursement from your insurance company.
At the end of each evaluation or therapy session, we will provide you with a superbill with appropriate diagnostic and treatment codes. The superbill is the form you will use if you intend to pursue reimbursement from your insurance company. It is your responsibility to submit superbills to your health insurance carrier as a receipt for speech therapy services.
Periodically, insurance companies will request additional forms of documentation in addition to superbills. We will gladly assist you and your insurance company by providing copies of evaluations, reports, progress notes, etc.
Some private insurance companies provide benefits for speech therapy evaluations and ongoing treatment, while others do not. In addition, some insurance companies will only reimburse for speech therapy if due to accident or injury, and will not reimburse for etiologies considered by them as developmental in nature (e.g., language delay or speech disorder).
It is your responsibility to determine what your insurance company will cover and whether you must receive their approval before initiating and continuing services. It is also your responsibility to fill out paperwork, pursue reimbursement, resolve claims issues, and appeal denials.
It is prudent to receive health carrier approvals for speech therapy evaluations and therapy in writing.
Recommended questions for your insurance carrier
Do you reimburse for speech pathology services?
Do I need prior approval before I can obtain an evaluation?
What is the scope of coverage?
Are benefits only for evaluation? Are there benefits for ongoing treatment?
How many treatment sessions per year?
What is your reimbursement rate for evaluations and treatment?