Speech & Language Pathology

Speech & Language Pathology

What to Expect From Us

Step 1: Complete the Allied Health Intake Form and Schedule an Evaluation.

The AH intake form provides a detailed account of important developmental milestones which will give the evaluator an idea of the concerns that need to be addressed during the evaluation. The evaluation is about an hour long. A parent will need to be present for the clinical interview, and to complete any evaluation forms. If the client has an IEP or 504 plan, we will need it during this session. If the client has a recent hearing screening, we will need this for the evaluation. Availability for these evaluations can depend on seasonality, but we can typically schedule within two weeks of the Intake Form being received. For most insurance companies, the evaluation is a billable service every 6 months.

Step 2: Evaluation Complete, Plan of Care Created, Qualification for Services.

Once the appointment has been completed, the evaluator then scores all materials and creates a write up of the Evaluation. If the patient qualifies for services, a Plan of Care (POC) is created by the evaluator. This POC outlines recommended treatment goals and a recommended frequency of treatment. At our practice, the average frequency of treatment for Physical Therapy is one 60-minute session per week. This frequency is subject to insurance approval. The average timeframe for a Plan of Care is around 6 months.

 Step 3: Primary Care Physician Approval, Insurance Authorization.

We send the completed Evaluation and Plan of Care to your Primary Care Physician (PCP) for their review, their signature on our Plan of Care, and a prescription for the service. More often than not, insurance authorization is required for this service. We send the reviewed Evaluation, and Plan of Care to your insurance company for prior authorization. If your child has an IEP/504 plan, we will need to send that as well. This step in the process can take up to 2 weeks depending on your Primary Care Physician and insurance company.

Step 4: Insurance Approval and Scheduling Reoccurring Therapies.

Once we receive the insurance authorization, a member of our team will reach out to update you on the outcomes of the request for services, frequency recommended and expected out of pocket charges for each session. Insurance authorizations are subject to any requirement the insurance company deems necessary.