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Insurance

Talk On, LLC is in network with the following insurance companies:

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Commercial Plan
 

  • Anthem Blue Cross Blue Shield of Ohio

  • Aetna

  • Cigna

  • Medical Mutual of Ohio

  • Summacare

  • United Healthcare

*be aware that there are some networks within commercial plans that we are not in network with*

 

Medicaid Plans

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  • AmeriHealth Caritas

  • Anthem Blue Cross of Ohio Medicaid

  • Buckeye Health Plan

  • CareSource Medicaid

  • CareSource Marketplace

  • Humana Healthy Horizons

  • Molina Healthcare of Ohio

  • United Healthcare Community

 

We will provide superbills for all other insurance companies.

We are in the process of contracting with other insurance companies as well, so please be sure to call and ask if you do not see your company on this list.

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Private Pay

If we are not yet in-network with your insurance company, we offer private pay solutions for your family.

Payments Accepted

We accept all major credit cards.

Jon Peterson Special Needs Scholarship
Autism Scholarship

Talk On, LLC is an Ohio Department of Education approved  Jon Peterson Special Needs and Autism Scholarship provider. Please contact us to learn more!

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What should I know about my insurance benefits for speech, feeding and occupational  therapy?

What are you expected to cover or pay?

All patients are responsible for all costs and fees that any third party payer does not cover

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Becoming Familiar With Your Insurance:

Insurance Card:
Review your insurance card: it shows you your member and group numbers/ ID, your plan type, and phone numbers to call for questions about your plan.

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Questions to ask when you call your insurance company

 

Speech Therapy CPT Code:

                   Evaluations: 92523

                         Sessions: 92507

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Occupational Therapy CPT Code:

                   Evaluations: 97167

                         Sessions: 97530

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Feeding Therapy CPT Code:

                   Evaluations: 92610

                         Sessions: 92526

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“Does my plan cover therapy?”

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“Am I responsible for a Co-Pay amount or Co- insurance?”

Copay: A fixed dollar amount you pay for certain types of care
Ex: If you have a $20 copay that is what you pay for the medical service whether the visit cost $40 or $400

Coinsurance: The percentage of the cost of the visit
Ex: if you have 20 percent coinsurance and the visit was $400 you are responsible for $80

“Do I have to meet my deductible in order for my insurance to pay for therapy services?”

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“What is my individual deductible?”

Deductible: This is the amount of money that you are required to pay in order for your insurance to start to pay towards services

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“Have I made any progress toward my deductible?”


“What will my insurance cover after my deductible is met?”


“How many yearly visits are covered for speech, feeding or occupational therapy?”

Ask if that is a "hard limit" which means that once that number is exhausted, therapy is no longer covered by insurance and anything that you pay will not go towards your deductible. If it is a soft limit we will have to request a pre authorization for sessions past the max limit.

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Does my plan have any diagnostic exclusions for speech, feeding or occupational therapy?

A diagnostic exclusion is when an insurance company will not pay for therapy if a person has specific diagnoses. Once you have a diagnosis code you should reach out again to your insurance to check if it is covered.

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“Is pre-authorization required?”

If a pre-authorization is required this means that your insurance company places restrictions on certain medications, tests, or health services. This requires your therapist to first check and be granted permission before your plan will cover the item.

 

Private Pay

Private Pay patients are responsible for service fees in their full amount at time of service

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