Usual and Customary Rates
Our practice is committed to providing the best treatment for our clients and we charge what is usual and customary for our area and for our services. You are responsible for payment regardless of any insurance company’s arbitrary determination of usual and customary rates.
You are expected to make payment on bills on time and in full. In the event that we are unable to collect any past due amount after a minimum of 3 attempts to collect, we may at our discretion refer the account to our collections agency. If we refer the account to a collections agency, you agree to pay the collections fee up to 25% of the total bill in addition to the account balance.
TPL Speech accepts insurance. Your insurance policy is a contract between you and your insurance carrier. TPL Speech is not responsible for and cannot affect how your insurance carrier processes claims or what the patient portion of the bill is. You will be responsible for un-covered charges processed through your carrier that are not contractual write-offs. Please inquire about the insurance we accept as this list changes.
Please make all co-payments at the time of service and payable to Talk Play Learn
Speech Therapy. You will be asked to save a card on file so that you co-pay is automatically paid the day of your visit, or within a week of your session. If you elect to use your insurance you agree to grant us the right to bill your insurance and you authorize your insurance carrier to assign benefits to us.
Accepted Methods of payment:
Cash: Exact change required.
Personal Check: Please make payable to Talk Play Learn Speech Therapy.
Credit/Debit Cards: MasterCard, Visa, Discover, American Express or your
Full payment is due to Talk Play Learn Speech Therapy at the time of service. Your
insurance policy is a contract between you and your insurance company. Please be
aware that some, and perhaps all, of the services provided by TPL Speech Therapy may be non-covered services and not considered reasonable, customary and/or medically necessary under your medical insurance plan. You may seek reimbursement for these services directly from your insurance company. If you are unsure about the process for filing a claim, we recommend that you call the customer service number on the back of your insurance ID card.
Speech-language services provided by Talk Play Learn Speech Therapy will likely be
considered out-of-network by your insurance company. Upon request, we will provide you with the information necessary to bill your insurance company, including diagnosis codes and treatment plans. This document is called a superbill and can be emailed to you.
We are not responsible for any charges your insurance company considers to be in excess of reasonable or customary fees as well as those considered medically unnecessary.
By the execution hereof, the undersigned acknowledges his/her/their responsibility to pay any amounts not paid or reimbursed by insurance. The undersigned specifically accepts all financial responsibility for all services provided to the herein named client by Talk Play Learn Speech Therapy and understands that regardless of what the insurance company agrees to pay, the undersigned will be responsible for the full balance. Said balance will be paid in advance of and without regard to the status of processing by the insurance carrier.