If you have a health insurance plan and intend to submit a claim for reimbursement…

A Good Faith Estimate of expected charges is available and will be provided to you in:

written form in clear language
verbal form when the service is scheduled, or when you ask about costs
accessible formats, in the language you speak and understand

If any information provided in the estimate changes, a new Good Faith Estimate will be provided no later than one (1) business day before the scheduled service.

It is a notification of expected charges for a scheduled or requested service. The expected charge for a service is either:
- the cash pay rate, established by a provider for an uninsured (self-pay) individual
- the amount the provider would expect to charge, if the provider intended to bill a health care plan directly for such a service
The information provided in the Good Faith Estimate is only an estimate, and the actual services or charges may differ from what is included in the Good Faith Estimate. However, uninsured or self-pay individuals may challenge a bill from a provider through a new patient-provider dispute resolution process if the billed charges, substantially exceed the expected charges in the Good Faith Estimate. Substantially exceed means an amount that is at least $400 more than the expected charges listed on the Good Faith Estimate for a specific provider.

Questions* to ask your insurance company in regards to your benefits.

My therapist is located and licensed in Ohio, California and North Carolina. I am located in __________.
Do I have out-of-network speech therapy benefits?
-What are they?
-Does my insurance plan cover telehealth or virtual sessions?
-What do I need to do to obtain reimbursement?
-How long does it take to obtain reimbursement?

Do you cover the following medical billing codes:
-92523 (Evaluation for Speech and Language)
-92522 (Evaluation for Speech)
-92507 (Treatment for Speech and/or Language)

-How do I get authorization?
-How many sessions will I be approved for?
-How many sessions are covered per week, per year?
-Is there a lifetime maximum for speech therapy benefits?

What is my annual deductible?
What is my deductible balance?
-What is the coverage per session before the deductible is met?
-What is the coverage per session after the deductible is met?

*This is not an exhaustive list. It is important to be familiar with your individual health insurance plan since benefits vary across policies. Payment is due at the time of scheduling a service.