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Insurance and Fees

Fees

Please add travel fees of $50.00 for initial assessments, and $35 for follow ups or ongoing therapy visits to all in home or on-site sessions. 

 

  • Initial Session/Assessment:

    • $200.00: This includes a full assessment of your child with a written a treatment plan/home program. This does not include a detailed written report, but goals/treatment plan only.  

    • $300.00: full assessment with detailed report. You must choose this option if you need a report with detailed information to share with other providers (e.g. ENT, Pediatric Dentist, Gastroenterologist, Tongue tie Release Provider, etc). Sometimes Insurance may ask for this documentation if you choose to submit a superbill.

    • Allow 1-1.5hours for this appointment.

 

  • Therapy Sessions:​

    • $115.00 per 45-minute session. 

      • 35 minutes of treatment and 10 minutes of documentation, planning and transitions

    • $80.00 per 30-minute session

      • 25 minutes of treatment and 5 minutes of documentation, planning, and transitions.

 

  • Wellness consultations, Parent Coaching, Meetings, Observations, additional reports, etc: $150.00/60 mins, $115/45 mins, $80/30 mins plus a travel fee if in person. 

All payments are accepted via our HIPAA compliant payment processor, Jane Payments. When you schedule your child's initial evaluation you will receive intake forms where you will input your credit card information or your HSA or FSA information to be kept on file. Your card will be charged at the time of service. 

  • You do not need a referral to seek speech or feeding therapy services.

  • You can use your HSA/FSA card to pay for services. 

Insurance

 

·You may be able to receive reimbursement from your insurance company for out-of-network providers. This is the responsibility of the family to arrange this with your insurance provider. We can provide you with a "superbill", which includes diagnostic and procedure codes that can be submitted to your insurance company. We ask that families act as the liaison for any direct communication with their insurance companies.

 

There are a few common things that many families do not realize regarding their insurance when deciding on in-network and out-of-network therapy options:

 

  1. You will have to pay out-of-pocket for services until you meet your deductible even if you see an in-network therapist.

  2. If the deductible is high (as many are these days) you may even be discharged from therapy before your deductible is ever met and your insurance begins covering services.

  3. Even after a deductible is met, the family is still responsible for coinsurance (most often 20-30% of the total cost).

 

It is important to understand your policy to make an informed decision about where to receive care. Our rates are below the standard cost of services in our area. 

So, when does it make sense to be sure you are with an in-network provider? 

If your child has a diagnosis where they will likely need ongoing therapy or other treatments that count towards your annual deductible long term (Autism, Down Syndrome, Severe behavior, etc). 

However, wait times for early intervention (Babies Can't Wait) and clinics that take insurance in the metro Atlanta area are long.

  • We are happy to see your child until they are able to get on the schedule of a qualified provider that is covered under your policy.

  • Early intervention is key, and if we can get your child started while they are on waitlists, we can easily facilitate a transition to an in-network therapist when a slot opens up. They will likely not have to undergo an additional evaluation at their new facility.

 

 

In- Network Insurance Needs

 

Jacqueline is passionate about connecting families with needed services! She has been a feeding/swallowing therapist in the clinic, hospital, and home health settings around Atlanta for over a decade developing a large network of therapists and related professionals. If you are having difficulty finding or accessing in-network (medicaid, medicaid CMO's, etc) feeding or related services for your child, fill out the form below and she will do her best to help.

 

 

Out-Of-Network Benefits Guide

Using your out of network benefits is often easier than you may realize!

 

This guide will assist you as you contact your insurance company to determine their process for filing out-of-network benefits. It should also help you determine if speech and feeding therapy benefits are included in your policy as well as how to submit a claim for potential reimbursement for the services you have already paid for.

 

 1. Call the member services phone number on the back of your insurance card.

 2. Tell the customer service representative you would like information about your coverage for Speech Therapy benefits with an out-of-network provider

  • Document your conversation:

  1. Name of customer service representative

  2. Date of call

  3. Time of call

 3. Have the following information ready & available in the event they need it:           

  • Insured’s Name:

  • Patient’s Name:

  • Date of Birth:

  • Insurance Member ID:

  • Policy/Group Number:

  • Provider 

  • State License: #SLP

  • ASHA Certification: #

  • NPI Number: #

*provider details will be provided via email upon request

 4. Ask these questions when speaking to the customer service representative:

  1. What is my coverage for speech therapy benefits?

  2. Do I need pre-authorization for speech therapy? If so, how do I obtain it?

  3. Can I submit a superbill?

  4. What is the process for filing a claim after I have a superbill for services?

  5. What additional forms do I need to submit when filing my claim?

  6. Where can I find the forms on your website? Can you email me a copy?

  7. Can I file my claim online or do I need to mail/fax it to you?

  8. Do I need to file my claim within a certain amount of time after the date of service?

  9. How long does it take to process my claim?

  10. Can I appeal if a claim is denied?

 

Your insurance company MAY request which charge codes & diagnosis codes will be used. We are unable to provide diagnosis codes until an evaluation has been completed.

 

CPT Codes:

Speech and Language Evaluations: 92523

Speech and Language Treatment: 92507

Clinical Evaluation of Swallowing and Feeding: 92610

Treatment of Swallowing Dysfunction and/or Oral Function: 92526

Submitting Claims

  • Most insurance companies allow you to upload a superbill (receipt provided at the end of the session with codes) in seconds on their web portal.

  • There is also an app called Reimbursify that streamlines this process.

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