FREQUENTLY ASKED QUESTIONS
You Ask — We Answer
DO I NEED TO PAY FOR ANOTHER EVALUATION?
If you are private pay and have an evaluation that was conducted within the last year, SLVS Therapy will use that same evaluation. Unfortunately insurance companies will require a new evaluation for services.
HOW DOES PRIVATE PAY WORK? OUT-OF-NETWORK BENEFITS?
Payment is due at the time of service. A detailed invoice (known as a "superbill") will be provided monthly. You can provide this invoice to your insurance provider to request reimbursement or I can submit on your behalf.
SLVS PLLC cannot bill any insurance company that we are not in-network with. If requested, we can provide you will evaluation results and treatment notes, but we are not responsible for insurance's coverage/reimbursement determinations.
SLVS Therapy will help to determine coverage; however, it is your responsibility to verify coverage.
Any payment arrangements and communication regarding coverage is between you and your insurance company.
You will need to call your insurance company to find out:
How to submit for reimbursement - what needs to be included, where to send it to, any time restrictions.
Before you call, be sure you have your current insurance card in front of you.
Write down the date, time of your call, as well as the representative’s name.
Tell the representative that you are calling to: check on your benefits and coverage for speech therapy.
See below for helpful questions when speaking with your insurance provider.
QUESTIONS TO ASK WHEN SEEKING REIMBURSEMENT
Under what circumstances does my policy cover speech therapy?
Does my speech therapy have an exclusion clause about covering therapy?
If yes, what is it?
How many visits are allowed per year of therapy?
Once those visits are used up under what circumstances can I get more visits authorized?
Have any visits been used to date?
Can I choose a speech therapist outside of our network/provider list?
Is there a requirement that I get a prior authorization and/or a referral before I see a speech therapist?
If yes, who do I contact?
Do I need any Pre-Authorization from my primary care doctor for speech therapy?
If yes, What do I need from my doctor? (e.g. prescription)
What is the difference for coverage of out-of-net-work vs in-network?
What is the deductible for out-of-network?
How much of the deductible has been met?
Do I have a co-payment or is there a percentage of the bill I will be responsible for out-of-network speech therapy visits?
Do I have co-insurance?
What is my out of pocket maximum?
What do I need to do in order to submit for reimbursement of speech therapy services?
Where do I send the superbill?
If anything is unclear, ask for clarification or speak with a supervisor. This will help avoid surprises after you submit for reimbursement.
Remember that you are responsible for all charges at the time of service. Your insurance coverage and any reimbursement is a contract between you and your insurance company. The above is only general recommendations and SLVS PLLC, is not responsible for coverage or reimbursement.
WHAT AREAS OF HOUSTON DO YOU SERVE?
Areas we commonly serve:
77002, 77006, 77007, 77008, 77018, 77019, 77024, 77027, 77046, 77055, 77056, 77057, 77098
Please contact us if you are not in the areas mentioned, but are seeking speech therapy services in-home or in the community. We do make exceptions.