Important Notice: The below listed information about reimbursement is hereby provided as a general overview, and should not be construed as a confirmation of reimbursement.    

 

REIMBURSEMENT

Insurance Coverage for Stuttering Treatment

STEP 1

1. Review your health care plan.
2. Contact your health insurance carrier and verify if coverage is provided for in your plan.
3. Important questions you should ask about your representative.
   • The need of a physician's letter for pre-approval purposes.
   • Request written confirmation addressing your concern.
   • When discussing your plan, it is useful to provide the following:
1. Diagnostic code (307.0)
2. Speech evaluation code (92506)
3. Speech treatment code (92507)

STEP 2
When there is no coverage

1. Get the representative's name, extension #, badge #.
2. Document the conversation.
3. Request written statement for the denial.
4. Appeal the decision.

STEP 3
The Appeal Process

1. Advise your health care insurance of your intention to appeal the denial.
2. Address the reasons for the denial.
3. Include a description of the disorder and its medical nature as well as a copy of the physician referral letter if applicable.
4. Get the assistance of your speech-language pathologist.
5. Response to your appeal should take no longer than 60 days.

If appeal is denied, you may want to contact your state insurance commissioner, and seek advice from the American Speech-Language Hearing Association.

 

 

 

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