PATIENT BILLING INFORMATION
Please read carefully
Your physician has prescribed speech (voice) therapy for your problem. Please contact your insurance company to determine if speech therapy is a part of your health benefit package.
Direct billing for your speech therapy to your insurance company will be completed for those companies with whom we have contracts. We will be happy to bill to your insurance company for insurances we do not carry, but we do ask that you pay for services at the time they are rendered. You are responsible for any balance your insurance company does not assume (i.e., co-payments, missed appointments, late cancellations).
If pre-authorization is necessary, please make these arrangements before your appointment. Typically, your insurance company requires a letter of medical necessity, which your physician needs to provide, and a speech therapy treatment plan, which is provided by your speech pathologist here at Exceptional Voice, Inc. Any other documentation required by your insurance company will gladly be provided.
We accept cash, checks and credit card payments (Visa, Master Card and Discover Card). All credit card charges are processed via a virtual terminal. We do not swipe your card, but write down your credit card information to use later to upload into the virtual terminal provided by a credit card processing company. Your credit card information is then shredded. We do not keep a permanent record of your credit card information. If you would like a receipt of your co-payments please ask.
It is our goal to provide the best possible care at the most reasonable cost. Fees are based on the amount of time devoted to the care of each patient.
· Initial evaluation (hourly fee): $225.00
· Follow up individual therapy (hourly fee): $150.00
· Half hour therapy session: $80.00
If you do not cancel within 24 hours or miss your scheduled appointment you will be responsible for a $65.00 missed-appointment fee. It is our goal to provide the best possible care and to treat all those who seek our help. Same day cancellation and missed appointments make it impossible for us to schedule someone on the waiting list.
Cash, checks and credit card (Visa, MC, and Discover) payments are accepted. Please make checks payable to: Exceptional Voice, Inc.
HIPAA (Health Insurance Portability and Accountability Act) regulations pertaining to transactions, privacy, and security apply to speech pathologists and audiologists who electronically bill insurance companies for their services or use a clearinghouse to do so. Please read and sign our HIPAA Privacy statement.
Kathe S. Perez, MA, CCC-SLP
Certified Speech-Language Pathologist
President, Exceptional Voice, Inc.
Last updated: September 1, 2014