We are in-network with the following insurance companies:
WellSense Health Plan, Harvard Pilgrim, Anthem BCBS, United Healthcare, and NH Healthy Families.
If your policy does not cover speech therapy services or if the coverage is limited, we recommend contacting your employer to see if they offer another plan that provides better coverage for speech and language services and switch to that plan during the next open enrollment period.
Contact us today to schedule a screening call!
Insurance frequently asked questions:
If my plan says I'm covered for speech therapy, why is there a cost?
Even with insurance, you usually have to pay for some of the costs. In most cases, when you go for speech therapy, you’ll need to cover a copayment, coinsurance, or deductible for each visit. The specific amount you have to pay depends on the plan you or your employer selected, and it’s determined by your health insurance company.
What's a copay?
A copay, or copayment, is a fixed dollar amount predetermined by your health insurance provider that is due at each appointment.
What is coinsurance?
Coinsurance refers to a predetermined percentage of the permitted amount for each appointment that you are obligated to cover. Suppose your health insurance plan includes an “80-20% coinsurance.” In that case, your insurance will cover 80% of the approved cost for the visit, while you will be accountable for the remaining 20%.
What is a deductible?
A deductible is the cumulative amount that you must personally pay before your health insurance begins to contribute towards any healthcare expenses. For instance, if your deductible is set at $1,000, you will be responsible for covering the entire approved cost for each appointment until you have reached a total of $1,000 spent on services subject to the deductible (specific health services may be exempt from the deductible, depending on your unique insurance plan). Essentially, you are fulfilling the payment that your health insurance company would have made if there were no deductible in place. Once your deductible is satisfied, your financial responsibility may change. You might then have a copay, coinsurance, or your health insurance could cover all subsequent healthcare expenses.
What if my plan isn't an accepted insurance provider?
We provide private payment options for therapy services. Additionally, you have the option to explore “out-of-network” coverage directly with your insurance company to determine if your plan offers reimbursement for such services.
Why should I use an in-network provider?
By being in-network with various insurance companies, we have established predetermined rates for each service we provide. This arrangement helps save you money! Our dedicated administrative staff takes care of billing directly to in-network insurance companies, enabling you to concentrate on your therapy and make progress without administrative burdens.
How do I know if I have out of network benefits?
When contacting your insurance carrier to inquire about “out-of-network” benefits, consider asking the following questions:
- Does my insurance plan provide coverage for “out-of-network” speech and/or occupational therapy?
- Is there an annual deductible for out-of-network speech and/or occupational therapy? If yes, what is the deductible amount?
- Are there any limitations on the number of visits covered per year for out-of-network therapy? If so, how many visits are allowed?
- What is the reimbursement policy for out-of-network benefits?
It’s important to note that some insurance companies establish an “allowed amount” that serves as a maximum limit for session fees they will cover. For instance, if your insurance has determined $100 as the allowed amount per session and applies a 25% coinsurance rate, they will only reimburse you up to $75, regardless of the therapist’s session fees.
In other words, if your therapist charges $200 per session but your insurance’s allowed amount is $100, you will only be reimbursed $75, and you will be responsible for the remaining $125.
How do I submit claim forms for reimbursement?
Claims are documentation that is submitted to your insurance company in order to request reimbursement for sessions that you have paid for out of pocket.
However, please be aware that if we are not in-network with your insurance provider, we are unable to submit claims on your behalf. Instead, we will provide you with monthly bills that contain detailed visit information. It will be your responsibility to submit these bills to your insurance company for potential reimbursement. While we cannot guarantee reimbursement for services, we will provide you with the necessary documentation to facilitate the reimbursement process. We understand that insurance can be complicated, so please feel free to reach out to us if you have any questions or need assistance.
