Here to Help
Insurance companies vary in their coverage for cognitive neurorehabilitation and specifically for home and community services. Our company does not participate in any managed care networks. We are considered an out-of-network provider. However, most PPO plans will pay a percentage of our services according to the reimbursement terms for out-of-network licensed professionals. We are available to assist in the often complicated and frustrating process of investigating insurance coverage and obtaining authorization for services. We use our extensive industry experience to educate funding representatives regarding the complex rehabilitation needs of a person with cognitive difficulties. OTOL Rx may also suggest “outside of the box” options to consider when researching benefits and coverage for prescribed neurorehabilitation services.
Language-Learning and Cognitive-Communication-Social Skills Services
This treatment is carried out by our licensed speech-language pathologists. Services are billed under the outpatient speech-language pathology benefits. Most insurance companies cover speech therapy sessions for a specific minimum number of sessions. Our company does not participate in any managed care networks. We are considered an out-of-network provider. However, most PPO plans will pay a percentage of our services according to the reimbursement terms for out-of-network licensed speech-language pathologists. Our office is available to contact your insurance company representative and to gather information regarding the terms of your policy coverage. We are also available to provide suggestions and guidance for claims submission.
Insurance Claims Submission
Our office directly bills workers’ compensation carriers when therapy for our services has been authorized. We do not directly bill private insurance companies. For private insurance (such as Blue Shield and CIGNA), our office will provide a weekly or monthly superbill that can be used for filing claims. This statement includes information similar to an insurance claims form, such as the dates of services provided, procedure codes, medical diagnosis code, and a total balance due. We are also happy to assist you in filling out any paperwork necessary for you to receive reimbursement. If any information is required by your insurance coverage, such as reports for service authorization, those will also be provided.