Insurance

insurance A WORD ABOUT INSURANCE

Good Talking People LLC is a private pay practice. We accept checks, major credit cards (Visa and MasterCard) or cash. We are not affiliated with any insurance companies and we do not negotiate our fees. You should know that insurance companies often list speech therapy as a reimbursable service but frequently will not provide coverage for children’s speech therapy services, particularly if the therapy is not due to a “medical” condition. If you plan to seek insurance reimbursement for any services rendered by Good Talking People LLC, you should check with your insurer as to their exclusions and requirements. We cannot tell you if your insurance company will ultimately reimburse you for services, even if it lists speech therapy as a covered service. If you intend to seek insurance reimbursement, you will need to do the following:

1. Get a referral from your child’s physician for speech language services specifying our name, as well as the amount of therapy time (e.g. 45 minutes, twice a week), or have your physician specify an evaluation. Bring that referral/prescription to our office. We also need a copy of your insurance card (front and back). If we receive a request from your insurance company for this information, we will be unable to process their requests without this documentation.

2. Any reports or documents, which are requested to be prepared for your child requires 2 weeks notice.

3. Insurance companies typically require a written initial assessment/evaluation. They do not accept information from your child’s IEP or school evaluations. This usually will trigger a denial on the grounds that we are duplicating school services or that the therapy is educational-not medical or rehabilitative in nature. We can use other private evaluations if less than 6 months old as the basis of treatment but you should inquire as to whether they will require a separate initial assessment before initiating therapy. Many insurance companies do require a formal assessment annually, which can be done at Good Talking People upon request.

4. We may be asked to forward all treatment notes related to your child’s care and we will need written permission/consent from you.

5. We will need to assign your child’s therapy a diagnostic code (ICD-9) and include it on your receipt. We require medical documentation in the form of a prescription or report that clearly states the diagnosis and diagnostic code (Autism, ADHD, etc) to confirm the diagnosis. Otherwise, we can only provide a speech/language based diagnosis and code.

6. Please make sure your insurance company writes and sends you the reimbursement checks directly to you. All checks sent to this office from an insurance company on behalf of a client will be returned to the insurance company with a letter directing them to reissue the check and send it to you. We cannot deposit the check or apply it as credit to your account or cosign checks that are received by our office in error.

7. Please know that we do provide any requested documentation to the insurance company in a timely manner, usually within a week. However, some insurance companies may indicate otherwise in order to delay the processing and limit their financial obligation to you.

8. For those who have a Health Savings Account (HSA) at your work, you can usually get reimbursement through your HSA or use your HSA credit/debit card as payment.