PAYMENT AND INSURANCE ISSUES
These are among the first questions or topics that I address since parents and their doctors are concerned about financial matters and the affordability of Orofacial Muscle Therapy (OMT) and Speech/Language therapies.
Every insurance company has its own policy on Speech-Language as well as OM Therapy. Currently I am on some insurance provider lists but if I am not on yours, since most do not have my specialty in-network, we are sometimes able to request an exception. However, in my experience only about 10% of the insurance plans will cover OMT disorders. Speech is sometimes reimbursed more readily. If you have an HMO type plan -- and in some rare cases a PPO--, you must generally ask your PCP (Primary Care Physician) to request to authorize my services as a specialist Speech-Language Pathologist (SLP) (do not use: "myofunctional", "tongue thrust" or “dental” terms) not available within the network...before our first session...or it will likely not cover anything—especially if an HMO. This is not usually a problem if a PPO or "points for service" plan--but check anyway.
If I am in-network or out of network, I do use and send in a universal standard insurance claim form that contains the information that most companies need. It is worth submitting the claim regardless of an initial negative response. I also can provide a written explanation supporting the need and an appeal letter if applicable. If the services are not covered, there are a few other options: use of alternative codes; Flex or Cafeteria plans; may apply toward the insurance deductible; and lastly deduct on income taxes.
I strive to keep my charges very reasonable and if no other arrangements are made, payment is due at the time of service. If warranted, I will work with patients on payment plans. For complete details on fees for screenings, evaluations and therapy(s), feel free to contact me.
I welcome inquiries about these important matters and the challenge of being both creative and flexible in order to provide therapy to everyone who needs it.
Please contact me regarding the appropriate codes to use for your specific case.
I accept payment via: Cash, Check, VISA, MasterCard, AMEX, HSA.
CHRISTINE LIVINGSTON, MA, CCC-SLP
Certified Speech-Language Pathologist & Orofacial Myologist
4465 Northpark Drive, Colorado Springs 80907
719-434-0888 (By Appointment Only)
Christine@LivingstonSLP.com