A Note on Insurance Coverage

You may have a health care plan that includes coverage for speech-language and occupational therapy evaluations and therapy. Although we do not accept insurance at SPS, we are more than happy to assist you with this process.

Look for coverage of all health related services under the major medical section of a traditional health insurance policy, or review the benefits booklet provided by your preferred provided organization (PPO), health maintenance organization (HMO), or self- insured employer. Your employee benefits manager is usually an excellent source of information about your health care coverage. There may not be a specific reference to speech-language pathology and occupational therapy. Look for terms such as "speech pathology," "speech therapy," or "hearing care." Speech-language therapy and occupational therapy may also be included in references to "rehabilitation services," "physical therapy," or "other medically necessary services or therapies."

Check for coverage limits and exclusions. Check to see if both evaluation and therapy services are covered. If possible, get clarification of your coverage in writing.

We do not accept insurance at SPS, and you are financially responsible for services rendered at SPS. However, we may be able to help assist you in receiving reimbursement for services rendered that are covered under your policy. If your insurance company denies coverage for services, you should appeal the decision if the plan indicated that the service was covered. Let us know that you have been denied.

Ask your physician to write a letter in support of coverage for the speech-language therapy and occupational therapy services received. In your appeal letter, point out statements in the insurance policy or benefits booklet that make you think these services are covered, for example, "other medically necessary services."