MarvelMyo & Speech is currently in-network with Medicare, Aetna (in Texas only), and Blue Cross Blue Shield. Blue Cross Blue Shield includes the following:
- BlueChoice PPO
- Blue Essentials
- HealthSelect of Texas
- Blue High Performance Network
- Blue Advantage HMO
- Blue Premier
- Blue Cross Medicare
- Advantage PPO
- Blue Cross Medicare Advantage HMO
We are considered an out-of-network provider for all other insurances. We advise that patients call their insurance about out-of-network benefits for speech therapy prior to scheduling an evaluation.
We provide a Superbill (receipt) with our coding for all out-of-network patients that can be submitted for possible reimbursement.
Payment and Benefits of Working with an Out-Of-Network Provider
Insurance authorization is not needed to start receiving speech therapy services. After an evaluation is completed, if we feel that the individual would benefit from speech therapy services, we are able to begin speech therapy services immediately without waiting on insurance approval.
Often times, insurance companies require a certain standard score or deficit to qualify for services. Working with an out-of-network/private pay therapist means that the individual does not have to score within a certain range to qualify for speech and language services. It also means that we have complete flexibility to tailor the individual’s treatment plan to target goals that are important to you, without worrying about any insurance restrictions.
A formal evaluation is not required. We understand that for some individuals, a formal evaluation is not feasible, or not the most realistic way to assess their current skill level. There are many comprehensive informal measures that can be used to assess the individual’s strengths and areas of need to help determine a treatment plan that is appropriate for them. We can provide a treatment plan that is fully customized to the individual’s specific needs.
You are not limited to a set number of visits per year or a set duration for treatment sessions. Often times, insurance only approves an allotted amount of sessions per year. By using an out-of-network provider, we are able to work together as a team to determine the number of sessions per week that works best for the individual and their family.
All payment is due at the time of service. MarvelMyo & Speech accepts payment via cash, credit card, or HSA/FSA cards. A superbill (receipt) can be provided, at your request, if you would like to seek out reimbursement from your insurance. We are happy to speak with you to help you understand what specific questions to ask your insurance provider.
It is each family‘s responsibility to confirm eligibility for speech services with their insurance provider prior to starting therapy. We are able to verify Medicare and Blue Cross Blue Shield benefits beforehand, however each family is responsible for any charges that insurance does not cover.
In order to provide the highest quality of care, we hold between 1 to 2 hours for each initial evaluation. Because of the lengthy amount of time that we hold on a therapist’s schedule, we require a $100 non-refundable payment to set the evaluation appointment. This payment goes towards your Myo Kit (tools we need for therapy) and the 30 minute consult to go over your treatment goals. If you reschedule with less than 48 hours notice of the evaluation appointment, a second payment of $100 will be required to hold a second evaluation slot.
