Insurance & Financial Information
LIFE Speech Pathology offers a variety of options to pay for your treatment.
Original Medicare part B
We are a participating provider with traditional or original Medicare (part B, outpatient). When you have original Medicare and/or a supplemental insurance plan, LIFE Speech Pathology will submit a claim for services rendered. For those who do not have supplemental insurance, a co-payment will be paid at the time of service.
Original Medicare will pay for services that are considered medically necessary. Your clinician will work with you to explain treatment that is covered and treatment that is outside the scope of medical necessity.
For treatment that is flexible, client-focused, and specialized, we offer out-of-the box concierge wellness treatment.
Out-of-Network Insurance
We are an out-of-network provider for all insurance companies. Many insurance companies offer out-of-network reimbursement for services.
If you have out-of-network benefits, the service will be paid in full on the day of services via a credit card on file. If desired, a superbill can be provided with the codes and necessary information. You'll submit the superbill to your insurance company and your insurance company will pay you directly.
We have created a Medical Insurance Benefit Worksheet. This worksheet will guide you to ask the questions of your insurance company to determine your coverage and benefits.
Download the Benefits Worksheet Here.
Out-of-the Box Concierge Treatment
We offer a Concierge Treatment option for clients who don’t have insurance benefits for speech therapy, have utilized their benefits, or want to continue to receive specialized treatment beyond the services that are considered medically necessary by Medicare and insurance companies.
The beauty of our concierge treatment is that you , the client, call the treatment shots. Treatment is highly client focused and can pivot from session to session, as needed, based on the client's wants and needs for communication. We offer both individual and group treatment.
The concierge program has a-la-carte pricing. Session rates are based on the time per session. You'll receive a good faith estimate when beginning treatment so that pricing is transparent. A credit card remains on file and is charged on the day of treatment.
Total treatment cost is based on the price per session. Treatment plans are based on the therapy needs of the client and are agreed upon with the client prior to the beginning services.
Frequently Asked Questions
I was just discharged from outpatient speech therapy last month. Will Medicare pay for my treatment?
Medicare utilizes a definition of medical necessity to determine what they will and will not pay for. If you were recently discharged from outpatient speech pathology, it is unlikely that you will qualify for additional treatment paid for by Medicare. However, we do offer a concierge treatment program that is private pay and can meet your continued communication goals and needs.
I was discharged from outpatient speech therapy nearly a year ago. Will Medicare pay for treatment?
Original Medicare part B will pay for treatment that is considered to be medically necessary. The best way to determine if treatment meets this definition is to have a consultation with one of our speech pathologists to determine your goals and to look into Medicare eligibility. There is no one-size-fits-all definition. If it has been a year since you were discharged, and if your physician agrees, you may be eligible for an evaluation and brief follow up treatment. LIFE offers a concierge treatment program that is private pay for any treatment you would like that does not fit the definition of medical necessity.
I have a Medicare Advantage Plan, will it pay for speech therapy?
Each Medicare Advantage Plan is different. You will have to determine if your plan offers out-of-network benefits, what the deductible is, and how to submit a superbill for treatment. If you select to move forward with treatment, you'll join our out-of-network program and will receive, upon request, a superbill that documents the treatment received. You can then submit the superbill to your insurance company and will be reimbursed directly by the insurance company to you. All out-of-network insurance clients maintain a credit card on file which is charged on the day of service.
Why don't you accept Aetna insurance?
There are as many insurance companies as there are states in the United States. LIFE Speech Pathology serves clients across the USA and we are not able to be credentialed with each insurance company, hence, we are out-of-network providers.
I want to continue treatment after Medicare. Can I do this?
LIFE Speech Pathology offers a concierge treatment program to continue the therapy that you want to receive. A credit card is maintained on file and is charged on the day of service.
I have original Medicare. I want to continue physical therapy at another location. Can I?
Original Medicare lumps physical therapy and speech pathology into the same reimbursement bucket. When the resources are close to being finished, each therapy has to justify medical necessity when the claim is submitted to Medicare. If you desire to continue treatment that is not considered medically necessary, there is often a concierge or wellness treatment program available to you for private pay.
Do you offer package pricing in the concierge treatment program?
Yes! We offer treatment packages that are designed for a 4-week interval and are paid up-front at the time of booking and receive a 10% discount.