Medicare: A claim will be sent to Medicare after each visit. Private Pay: A superbill/receipt will be provided after each visit to submit to your insurance for reimbursement for out-of-network services
Questions for Reimbursement
Call your insurance company
Have your insurance card with you
Write date/time and representative name
Check on your benefits and coverage for speech therapy
If anything is unclear, ask to speak to a supervisor
Questions
Does my policy cover speech therapy?
Are there any exclusions to covering speech therapy sessions?
How many therapy visits are allowed per year?
How many visits do I have available?
Am I able to have more visits approved if I run out?
Can I choose a speech therapist outside of network/provider list?
Pre-Authorization Requirements
Do I need to get a prior authorization and/or a referral before I see a speech therapist?
If yes, who do I contact/what is their number?
Do I need a Pre-Authorization from my primary care doctor for speech therapy?
If yes, what do I need from my doctor? (prescription)
Reimbursement
What is the difference for coverage of out-of-network vs in-network?
What is the deductible for out-of-network?
How much of the deductible has been met?
Do I have a co-payment or is there a percentage of the bill I will be responsible for out-of-network speech therapy visits?
How much?
Do I have co-insurance?
How much?
What is my out of pocket maximum?
Submitting Reimbursement
What do I need to do in order to submit for reimbursement of speech therapy services?
Where do I send the Superbill?
The information provided are suggestions from Fairmount Speech and Swallowing Therapy. Coverage or reimbursement are not the responsibility of Fairmount Speech and Swallowing Therapy.