Will my health insurance cover this service?
Every insurance policy is different, so you need to check the specific terms of yours. If you do have coverage, be sure you understand possible restrictions such as the number of sessions per calendar year, frequency and duration of services allowable, and coverage only for specific diagnostic codes that may be applicable under your policy. You also need to be aware of deductibles and percentage of coverage. Under some policies a medical necessity, as evidenced by a note from your physician, is required. PPO, HMO and Point of Service plans may or may not permit you to choose your own provider.
FDH attempts to work with insurance companies whenever possible as an in-network provider with Blue Cross Blue Shield, Aetna, Cigna, and an out-of-network provider for others. This does not mean your insurance company will cover our services. Unfortunately, there are times when insurance companies can deny payment of claims, even after initial authorization. This is out of the control of FDH. In addition, it is common for families to have a deductible before the insurance company will begin paying on a therapy service.
Furthermore, many insurance companies do not offer an affordable payment rate to compensate for the clinical time and expertise required to complete an evaluation or for the costs of treatment. Therefore, payment is made from the families to FDH and we will work with the family for self-pay options. FDH will submit the insurance claims for you as a courtesy for the family to attempt to recover possible payment/reimbursement from insurance. Clients are responsible to pay FDH, LLC directly for services rendered. All copays are due at the time of service for individual speech therapy appointments. FDH reserves the right to discontinue services in the event that families do not adhere to payment agreements and policies.
The cost for an initial evaluation is $950.00. The evaluation cost comprises the testing time with your child, scoring and interpretation, report writing, and face-to-face consultation time to review findings and discuss treatment and/or program recommendations.
Speech and Language therapy sessions are $95.00 per hour. In the event that therapy is recommended for your child to come in 2 or more times a week, the therapy session rate is reduced to $75.00 per hour. This reduction in rate is only applicable for private pay circumstances.