A few weeks ago Gus was telling us a story and I thought, “Gol, his speech is kind of a mess. I should get that fixed. It’s probably because of those big beautiful cheeks making it laborous to talk.” And then naturally I went on with my day.
The next day John asked me “Do you think we should get Gus’s speech checked out?”
And then I felt like the worst mom/speech therapist. Ever.
So we got him evaluated. And my husband had a million questions about how it worked and how it gets covered by insurance. And I went through the whole speil of how it all goes down – the same one I do with parents. And then I thought, “This would be a good blog post.” So here it goes!
How does therapy payment work?
I learn by example, so that is how we are going to do this here.
Gus has some sloppy speech. We need to get it fixed.
I called a speech therapist – another one that works at Bloom – (because you and I both know doing therapy with your mom is not going to go down well.) I told her we would like him evaluated and she set up a time.
We went in and she assessed his speech with a formal test. She showed me the scores and showed me a comparison score of other children his age. He had a few spots we would like cleaned up, so we decided to proceed with therapy.
The bill for the evaluation was sent to the insurance company for processing.
The evaluation report then gets sent to insurance to see if they will cover requested therapy sessions. Some insurance companies cover, and some do not. If Gus’s evaluation does not get covered, we will use an FSA or HSA card to pay for it.
If we have not met our deductible yet, the costs will go towards our deductible. If our deductible is met, it will be covered, and we will pay a small co pay – like $20 or so. Well worth it.
Some insurance companies will cover a length of time, while other companies will cover a certain amount of sessions. When that time is up, the therapist will have to write a request for more sessions.
Each session will be billed to our insurance company and we will receieve bills if our deductible has not been met or just pay copays if our deductible has been met. Pretty simple. (However, some insurance companies take months to respond – I won’t name any names – so this can be hard and super annoying!)
I will keep you posted on Gus’s speech therapy. All I know now is that he reported “My think my love Miss Morgan.” Because speech therapists are the coolest.