I-xcel now accepts Medicaid
Posted on June 30, 2009
If You Intend to Seek Insurance Reimbursement
UPDATE: As of APRIL 2009, I-xcel now accepts Medicaid!
We accept check, major credit cards, or cash. I-xcel does not routinely directly bill private insurance companies. We will support you by providing appropriate documentation of the speech-language services we provide if requested and encourage parents to file on their own. In some cases, I-xcel will file insurance for you, but an administration fee for doing so is assessed. There are no guarantees of insurance payment on your claim.
If you plan to seek reimbursement, you must let your therapist know before beginning therapy and the following are required:
- Child’s pediatrician receives evaluation report and writes a prescription for speech language therapy with the appropriate diagnosis code for your child’s file.
- Copies of your child’s treatment notes are available to you when requested by your insurance company. It will be your responsibility to send your insurance company additional information requested such as evaluation report or treatment notes from therapy sessions. Keep in mind that if your insurance company requires a report of progress every quarter or every six months (in addition to regular treatment notes), these are prepared for you at a set rate per report.
- Other than Medicaid, I-xcel is an out of network provider with all private insurance companies.
Understanding Your Policy
What kind of policy do you have?
HMO, PPO, POS, etc.? Typically, HMOs require you to see a participating provider (someone that has contracted their services to that insurance company for a set fee). PPOs and POSs allow you to receive services from professionals that are “out of network”.
Check your policy booklet or call your insurance company to find out about your benefits. Look for terms like “speech therapy”, “speech-language pathology”, “physical therapy and other rehab services” or “other medically necessary services or therapies” to see if it is a covered service.
Understand if there are any limitations in your insurance policy. These may be in the form of specific diagnosis and/or certain number of visits per year. We will not become involved in disputes between you and your insurance company regarding plan benefits, deductibles, co-payments, co-insurances, covered charges, coordination of benefits, “usual and customary” charges, etc., other than to supply factual information as necessary. You are responsible for the timely submittal of claims submitted to your insurance company.
Is Pre-Approval Required?
Your policy booklet or your insurance representative may clarify if a referral or pre-approval is needed for treatment or an evaluation.
If a referral is required for pre-approval, be sure to get the referral from your primary physician before your child begins treatment. This referral may be a form your doctor fills out or he/she may be required to write a letter of referral.
Often the insurance company will pre-certify a specific number of therapy sessions over a specific amount of time. If so, request the pre-certification letter be mailed directly to you so that you may keep track of the number of visits.
Keeping Good Records
Start a file and keep an accurate record of all conversations with the insurance company representatives you speak to. Always write down their full name and telephone extension number. Keep a copy of all written correspondence. Have your policy ID number handy when calling them and include it on all correspondence to the insurance company.
Submitting A Claim
If your child receives speech-language treatment once or twice a week, claims may be submitted at the completion of each session or after a block of sessions. If more sessions are needed at the end of that time, documentation of progress may be requested by the insurance company in order to approve additional sessions. Your insurance company is required to notify you of their decision within 30-60 days.
If you are told that treatment for your specific diagnosis is not covered, request the reasons in writing. This will be helpful to have in the event of an appeal. By the same token, if you are told your treatment will be covered, request that information in writing as well. Often an insurance company will consider reimbursement for services if they are medically necessary. They often deny claims that they deem educational or developmental in nature.
Always keep copies of everything you send to the insurance company in your file. Also, call the insurance company a week after you have mailed your claim, or a day after you have faxed it, to confirm that it has been received.
Often reimbursement takes time; it may be a lengthy process and require you to make follow-up phone calls. If you have not heard from your insurance carrier within 2 weeks, we advise you to be proactive by contacting them and making sure they have all of the information they need to process your claim.
How Can I-xcel Speech and Language Help Me?
We will provide you with an itemized invoice that will list all of the codes necessary to seek reimbursement. Keep in mind that if the insurance companies require reports of progress every quarter or every six months (in addition to regular weekly treatment notes), these are prepared for you at a set rate per report.
I-xcel is available to help you determine your insurance benefits.
Call for more information! 404-966-9496
(Effective January, 2009)
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Famous people with speech problems
Posted on June 29, 2009
Bruce Willis - Walter Bruce Willis (born March 19, 1955) is a German-born American actor and singer. He came to fame in the late 1980s and has since retained a career as both a Hollywood leading man and a supporting actor. Being the leading actor in some of the greatest action movies Bruce Willis has had stuttering problems throughout his youth and was always scared it would affect his acting career. Fortunately he successfully grew out of it not too much from a therapist but from being an actor, it actually removed his speech disorder.
See a full list of all the people you know with speech problems here…you may be surprised - Allyson