Know Your Insurance + Benefits.
CommuniKate Speech Therapy is credentialed and contracted with a variety of insurance companies, meaning all you need to do it provide us with your plan and member number and we take care of the rest!
For all insurance companies not listed below, we can provide a superbill for you to submit to your insurance provider to be considered for reimbursement. There is no guarantee of reimbursement for out of network plans and it is up to each plan how much they will reimburse, if at all.
We are credentialed, contracted, and considered in network with: Aetna, Blue Cross Blue Shield, Cigna, First Health, HMA, Meritain, Tricare and United Health.
We are contracted as an approved out of network provider for Providence. We can also accept payments through an HSA as well as private pay.
How do I Get Information About my Speech Therapy Benefits?
Call the number on the back of your card under customer services/members tell them you want to get information regarding your benefits for speech therapy services.
They will ask if you are going to an in network or out of network provider. We are in network with: Aetna, Blue Cross Blue Shield, Cigna, First Health, HMA, Meritain, Tricare, United Health.
What They May Ask For:
CPT: 92522 for an evaluation and 92507 for therapy.
ICD10: generally an F code, F80.0 for articulation, F80.1 for expressive language, F80.2 for mixed receptive-expressive, F80.81 for stuttering.
Ask specifically if there are any exclusions to this benefit.
Ask about your deductible amount and if this service goes towards your deductible (meaning you have to meet your deducible before your benefits kick in).
Ask if prior authorization is required.
Before you hang up with them ask for a call reference number.
What is a Deductible?
A deductible is the amount you have to pay BEFORE your benefits kick in. If you have a $500 deductible, you pay the insurance contracted rate (different for each insurance company) until you have paid $500. Only then will your benefits cover costs of services.
What is a Copayment?
A copayment is the amount due for each visit regardless of your deductible. Generally, if you have a copay amount, the service does not go towards your deductible.
What is Co-Insurance?
Co-insurance is a percentage that you are responsible for AFTER your deductible has been met. If your co-insurance is 20% that means your insurance company with cover 80% of the contracted rate, and you are responsible for the remaining 20%. Remember this is AFTER you have paid your full deductible amount.
What is Prior Authorization?
Some insurances require approval before a service is completed. This means additional paperwork BEFORE sessions start. They will generally approve a specific number of visits (12 is the usual) and then notes need to be submitted showing progress before treatment can continue. We do all of this on our end, but it is good for you to be aware of in case there’s a pause in services while we wait for approval.