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Insurance Information.

I am an “In-Network Provider” for Medicare.

​I am an "Out-of-Network" provider for all other insurance plans.

What that means is that you will be responsible for paying your fee at the time of your appointment, and you may be able to use your Out-of-Network Benefits to reimburse you for your fees. Speech-language services are often, but not always, covered by insurance.  Before making an appointment with me, you may want to call your insurance to ask about coverage conditions.  Provide the following:

  • Your specific plan number

  • My contact information

  • What services you require

  • CPT codes for those services. The evaluation session is CPT code 92524 (Behavioral and qualitative analysis of voice and resonance. Treatment sessions are CPT code 92507 (Individual treatment session) or CPT code 92508 (Group therapy session)

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CPT Codes are how services are recorded for insurance reimbursement.  Use the listed codes to determine what your coverage is.

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I will provide you with a statement with all the necessary information that you can submit to your insurance company.​

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Please note, even with a diagnosis code, there is no guarantee that your insurance will reimburse you.  Here are some steps you can take with your insurance company to learn more about your benefits:

CALL

Call the number on the back of your insurance card & ask about your Out-of-Network (OON) benefits.

Ask to speak with someone regarding Out-of-Network benefits for Speech-Language Services or Speech Therapy.

REQUEST

Request approval for an intake and assessment/testing, and therapy sessions

 

Evaluation of Voice and Resonance 92524

 

Individual Speech Therapy 92507

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Group Speech Therapy 92508

FORMS

Ask if you must complete a form, and if so, request a copy of this form.  Ask where the form should be faxed or mailed and make a note of it.

Keep record of your phone calls with the insurance company and the information they provided.

GET INFORMATION

Ask the insurance company what dollar amount you will be reimbursed for the CPT codes.  They may say they will reimburse you based on a percentage.  However, this is a percentage based on what they determine to be the “usual and customary rate” (UCR) – this is not necessarily the percentage of my fees.

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