Will my insurance cover therapy visits?
We recommend you being proactive in verifying your child’s benefits with your insurance carrier. Before your first appointment contact your insurance carrier to determine your child’s therapy benefits. Benefits are plan-specific, therefore insurance coverage does not guarantee coverage for therapy. We use the information obtained as an estimated guideline. Most insurance companies will reimburse for the initial speech and language evaluation.
Your child’s pediatrician should provide a diagnosis that is most appropriate to characterize their difficulties. The diagnosis code will be requested by your insurance company. Insurance companies tend to reimburse for diagnoses that are “disturbances or disorders” but not “developmental” diagnoses (e.g., speech delay). Before visits begin you will need the original prescription or written diagnosis from the referring physician for the evaluation and treatment of speech for your child.* Required from physician if filing with Insurance or Medicaid. This is required to document medical necessity. Additional documents may also be requested/required from your insurance company.
To initiate therapy request through your insurance carrier, submit a speech and language evaluation that has been completed within the past 6 months. The evaluation will be submitted to your insurance carrier for prior authorization to approve therapy. Include supporting documents (i.e. current IEP or IFSP), as they are required for submission. Please be advised that it may take 2-4 weeks to receive approval to start therapy. Email your evaluation to [email protected] or fax a copy to 404.996.1333.
Before the first appointment all of the following must be received:
- Patient Intake Forms
- Original Prescription from Referring Physician
- Copy of Insurance Card or Medicaid Card (Front & Back)
- Copy of Driver’s License (Front & Back)
- Copy of IEP (school) or IFSP (Babies Can’t Wait)
- Consent to Treat Form
- Cancellation/Financial Agreement
Atlanta Speech Pathology provides in-network billing with the following insurance carriers: Amerigroup, Aetna, Coventry, Deeming Waiver (Katie Beckett), Humana Military, Medicaid, Peach State, Tricare, and SSI. Courtesy billing is provided for out-of- network billing to all other insurance companies. Contact us at 404.228.0947 for any additional questions related to insurance and/or self-pay options.