Coverage Verification 

It is your responsibility to be informed of your insurance benefits prior to your initial visit.  Contacting the insurance company directly will help you understand your plan and how benefits may be applied. Helpful questions that may help you understand your plan are:   

  • What are my in-network benefits for XX​ (occupational, physical, speech therapies; applied behavior analysis; psychological testing/therapy)?
  • Do I need pre-authorization for these services?
  • Do I need a physician referral for these services?
  • What is my deductible?
  • What is my co-pay or co-insurance?
  • Do I only pay one co-pay if I have more than one service on a day?
  • What is my annual limit for these services?
  • How many therapy visits are covered per year?  Is there a combined benefit between occupational, physical and speech therapy?  
  • Are any diagnosis excluded that I should be aware of?
  • Is Building Bridges Therapy Center an in-network provider? (our tax ID is 20-0706090). 


 Be sure to note the date and the name of the person that spoke with you.  

  • Each client is solely and individually responsible for all fees for services provided. If aninsurance company does not pay for service, it is ultimately the client's responsibility.
  • If you have insurance, we will help to verify your coverage for our services. However, it is your responsibility to know what your insurance company covers and what it does not cover. Different plans and employers may result in different benefit provisions. It is up to the client to determine if services are covered under their particular insurance plan.  
  • ​Please inform us immediately if any part of your insurance coverage changes. Often insurance companies require per-approval or authorization.They may not retro-date authorizations, which may result in a period in which you are personally responsible for payment for services.  
  • If a referral is required for services, please obtain this prior to your initial visit.

Common Insurance Terms

General



Deductible:
The deductible is the amount you are required to pay before your insurance begins payment for care. Deductibles vary in size and may renew at either the calendar year or plan year depending on your individual policy. 

Co-Pay:
Some insurance contracts require you to pay a certain dollar amount each visit. This amount is called a co-pay. Co-pay amounts can vary, depending on your individual policy.  Depending on your plan, you may only be responsible for one co-pay if multiple sessions occur on the same day.

Co-Insurance:
This is the percentage that your individual policy requires you to pay of the allowed or contracted amount. We will bill you for your co-insurance amount once we determine what your carrier allows per visit.

Plan Design:
Plans may have a deductible, co-pays,
​co-insurance, or any combination of these features.  


Out-of-Pocket Maximum:
The maximum amount that you may be responsible for in a year. This may or may not include prescription costs or co-pays.


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