Frequently Asked Questions
Q: Do you take my insurance?
A: At this time we are accepting private insurance plans Anthem/BCBS, Aetna Ohio, and Medical Mutual of Ohio (MMO). If your insurance is not one of the above and your policy has out-of-network speech benefits, you may be able to submit provided invoices/superbills to your insurance company and the company may directly reimburse you, based on the terms of your insurance policy. We provide the superbills, but we do not have the staff necessary to contact your insurance company. Most private insurance companies cover one evaluation per year, excluding co-pays, co-insurance, or deductibles. Some private insurance companies will only cover speech therapy if it is due to an accident or injury or if there is a medical diagnosis (ex. autism, cerebral palsy, or head injury). Some insurance policies require a co-pay or co-insurance per therapy visit.
We cannot accept Medicaid patients at this time. This includes insurance plans such as Paramount Advantage, Buckeye Health Plan, Molina Healthcare, CareSource, Atena Better Health of Ohio, and United Healthcare Community Plan. We also cannot accept patients who have any such Medicaid plans as their secondary insurance.
Q: Do I need a referral/prescription from my child's pediatrician?
A: Yes, our office requires a referral to proceed with an evaluation or therapy. It is best practice to have a referral from a doctor. If you are going through your insurance company, an HSA, or an FSA, or if you are planning on getting reimbursed by your insurance company, a referral is definitely required.
Q: What should the referral/prescription say?
A: The referral/prescription must have a diagnosis code (examples include: F80.0; Phonological Disorder or F80.2; Mixed Receptive-Expressive Language disorder) and should say "evaluate and treat". The referral can be brought in person on the day of the evaluation or can be faxed to (866) 390-9167.
Q: If you don't take my insurance, what are the costs for private pay?
A: Our fee schedule for private pay is as follows:
- Speech Evaluation: $150
- Speech and Language Evaluation: $300
- Speech Therapy Sessions:
- 30 min: $60
- 45 min: $90
- 60 min: $120
Again, we cannot take Medicaid members as private pay.
Q: Do we have to do an evaluation?
A: Yes. It is best practice to start with an evaluation so that the therapist can collect history, determine strengths and weaknesses, and set goals for therapy. If your child has been evaluated by a speech therapist outside of our organization within the past 6 months, that evaluation may be used to proceed with therapy.
Q: Tell me more about teletherapy.
A: We use a secure and HIPAA-compliant interactive platform called Theraplatform for teletherapy. For teletherapy, we can only accept patients who live in the state of Ohio. Most insurance companies do not cover teletherapy so the private pay rate would apply.