Payment/insurance faq

As a parent, I'm sure you have questions about payment and insurance. We hope we can answer your questions here. If not, please reach out to Emily at 8149540288 or emily@aboveandbeyondspeechtherapy.com

Yes - we are in network with Highmark at this time. We do not accept Medicaid/Medical Assistance.

Please be aware that some, and perhaps all, of the services provided by ABOVE AND BEYOND SPEECH THERAPY may be non-covered services by Highmark and not considered reasonable, customary and/or medically necessary under your medical insurance plan. We are not responsible for any charges your insurance company considers to be in excess of reasonable or customary fees as well as those considered medically unnecessary. So even though we are in network with Highmark, that does not mean Highmark will automatically pay for speech therapy. After a claim is submitted, if any balance remains, the person in charge of payment is responsible for the balance to be paid to ABOVE AND BEYOND SPEECH THERAPY. 

Short answer: You may seek reimbursement from your insurance company - or pay out of pocket completely. We are very upfront with fees. 

You will pay ABOVE AND BEYOND SPEECH THERAPY on the day of service using cash, check, or credit card (preferred). An HSA card can be used for payment for sessions, but a regular credit card will also have to be on file in case of fees for late cancels/no shows. 

Longer answer: If you would like to seek reimbursement for these services directly from your insurance company, ABOVE AND BEYOND SPEECH THERAPY is then considered an out-of-network provider. We will provide you all information requested from the insurance company, including diagnoses codes and treatment plans. If you are unsure about the process for filing a claim for an out-of-network provider, we recommend that you call the customer service number on the back of your insurance ID card. Your insurance policy is a contract between you and your insurance company. Please be aware that some, and perhaps all, of the services provided by ABOVE AND BEYOND SPEECH THERAPY may be non-covered services and not considered reasonable, customary and/or medically necessary under your medical insurance plan. We are not responsible for any charges your insurance company considers to be in excess of reasonable or customary fees as well as those considered medically unnecessary. You will have to pay this amount. **If you are interested in pursuing insurance reimbursement, please let us know before your child’s first session.

If you are NOT looking to get reimbursement for these services directly from your insurance company, you will be provided with a Good Faith Estimate explaining how much your medical care will cost. Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services. You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees. Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service. If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate. For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises. Also, you can read more here: https://www.apaservices.org/practice/legal/managed/good-faith-estimate-notice.pdf and here: https://www.apaservices.org/practice/legal/managed/good-faith-estimate-template.pdf?fbclid=IwAR0kWTZgT3jeBPDgbXtsMREdmhKK0eZuSWaZgMYrBQFeZ0ePO1W4pBCgKPU and here https://www.cms.gov/newsroom/fact-sheets/requirements-related-surprise-billing-part-ii-interim-final-rule-comment-period

Payments can be made by cash, check, or credit card (preferred). An HSA card can be used for payment for sessions, but a regular credit card will also have to be on file in case of fees for late cancels/no shows. 

Payment is due at the time of each session. If you have Highmark, then you'll pay a copay or coinsurance each session. If you do not have Highmark, then you will pay and can choose to get reimbursement from your insurance company if you would like. 

Many health care professionals do not work directly with insurance companies, choosing instead to work as out-of-network providers. This ensures that your health care professional makes medical decisions that are purely based on professional expertise and not on health insurance plan policies. 

Call the customer service phone number listed on your insurance card. Ask, “I want to work with an out-of-network speech language pathologist, how much will you reimburse me?” 

Be sure that your insurance plan benefits are clear to you - what should your health plan cover? What health services count toward your deductible?

Call the customer service phone number listed on your insurance card. Ask, “What is the best way to submit my claim for reimbursement for speech therapy with a superbill under my insurance plan?” And make sure to keep a photocopy of all the documents you send in for your records.

1. Understand and agree that you are financially responsible for all charges for any and all services rendered.

2. Understand and be informed that a superbill does not guarantee that an insurance provider will pay for the services provided. Each insurance plan is different, and it is your responsibility to contact your insurance provider and find out exactly what will be covered.

3. Understand and be informed that should you choose to submit a superbill, you are releasing medical information that is protected by law. This means you are waiving some of your rights to privacy and confidentiality by sending this information to your insurance company. It is standard for the insurance company to keep a record of the diagnoses stated on the superbill as part of your permanent medical file.