Health Insurance Qualifications

It is important that you review the speech and hearing benefits information provided by your health plan before you receive services.

We work with most major insurance plans including Blue Cross/Blue Shield, Cigna, United Healthcare, and TriCare Insurance in support of our local military families.

Health benefit plans vary widely depending on the benefits and coverage levels of your plan. Sometimes, the benefits information on your health plan can be confusing.

Remember, the benefits booklet you receive is merely a summary of benefits and not the actual contract language. You may need to carefully examine the policy itself to truly understand your health plan’s coverage and limitations. When in doubt check with your insurance provider to confirm your benefits.

Contact us for more details on our insurance plan credentials.

Understand Your Benefits

Coverage information for speech services may be included under ” physical therapy and other rehabilitation services ” or “other medically necessary services or therapies

Coverage of evaluations and/or assessment are “testing” and treatment is “therapy” services for most speech disorders.
Limitations and exclusions are typically located in a separate section, and might be referred to as “Things We Don’t Cover” or “Exclusions to Coverage”.

Common limitations and exclusions include:

When in doubt, check it out! If you are unsure about the coverage your health plan provides for speech or feeding services, call the 800 number listed on your ID card and speak to a customer service representative. Request that they provide any clarification of your coverage in writing.

Remember to keep copies of all documentation, including date, time, and contact person!

Get Permission
Before Your Visit

Your health plan may require that you obtain prior approval or that a physician “prescribe” speech or feeding services.

This may also be referred to as “pre-authorization”, “pre-certification” or “pre-determination”. Read on to find out the subtle differences between these three terms.

Every health plan is different, so you’ll need to call the 800 number listed on your ID card and speak to a customer service representative to determine what speech or feeding services need prior approval.

Unfortunately, prior approval does not always guarantee coverage. So, always check with your health plan before having any service performed.

Remember to keep copies of all documentation, including date, time, and contact person!

EDUCATION VS OUTPATIENT SERVICE MODEL

Children may have access to speech and feeding services through the school system as well as through the medical system. Each system, however, has specific policies.

For example, school systems provide speech services only to children who qualify under a very rigid set of federal regulations and state education laws. Children who do qualify for speech services in the school system may be placed on a waiting list. Furthermore, speech-language pathologists, who provide speech services in the schools, typically have more children on their caseload than recommended. Supplemental therapy, from a independent therapy provider outside of the school system, reduces the time children spend in treatment.

Only when families seek (ask) supplemental services from their health plan, do they discover that the majority of health plans will not pay for services that may also be provided in a school setting. As a result, the child may become a ping-pong ball that bounces between the school and medical systems, and not receiving needed services.

Communication disorders affect an individual’s health and education simultaneously. Therefore, children are best served when providers (speech-language therapists) from both the school and medical systems work collaboratively to identify the best treatment setting for each child. Many times, children attain their best potential by being served in both settings simultaneously.

Mary Adams

What is one unique fact about you?
My daughter and I love doing charity work.

Where is your favorite place to vacation?
Cabo San Lucas

What is your favorite children’s book?
“The Giving Tree” by Shel Silverstein

Do You Have Any Pets?
Ginger -dog

What do you like to do for fun?
Read, Yoga, travel, and watching the kiddos play sports

Who is your hero and why?
My dad who has shown me to always have a positive outlook on everything In life and growing up he was very driven to work hard for the family.

What is the best thing about your job?
I have to stay organized and that is one of my best qualities.

Nicole Tsao

MS, CCC-SLP, CAIP

What is one unique fact about you?
I used to participate in a lion and dragon dance team

Do you have a favorite children’s book?
Esperanza Rising by Pam Muñoz Ryan

Do you have any pets?
I don’t have any pets but dream of adding 2 dachshunds to my family one day.

What do you like to do for fun?
I like to garden, cook/bake, draw, play video games, and hang out with my family

Who is your hero and why?
My heroes are my parents and grandparents who selflessly work so hard to provide for their families.

What is the best thing about your job?
I love getting to collaborate with a great team of SLPs and building relationships with tons of great families. One of my favorite things is seeing children make progress on their goals and become more confident about being themselves.

Maggie Olson

MS, CFY-SLP

What is one unique fact about you?
I have a twin brother! We are fraternal twins.

What are your hobbies?
I love to exercise and try new recipes or restaurants- I am a big foodie!

What is your favorite children’s book?
Junie B. Jones series

Do You Have Any Pets?
In graduate school, my 4 roommates and I fostered a newborn puppy while living together. We loved him so much that my roommate adopted him. Although we don’t live together anymore, all 5 of us are still considered his “moms”. His name is Goose and he is in training to be a therapy dog!

What do you like to do for fun?
I enjoy running, spending time with family and friends, reading, traveling, and especially finding a new farmers market on the weekend!

Who is your hero and why?
My parents! They have taught me the importance of family, tradition, and time together. I appreciate them more than anything, especially since moving farther away from my hometown.

What is the best thing about your job?
The best thing about my job is the connections I get to make with each kid. Every day is so rewarding!

Celinda Acosta

MS, CFY-SLP

What is one unique fact about you?
I once hiked through a lightning storm while backpacking in Northern New Mexico, my home state!

What are your hobbies?
I love rock climbing, yoga, and finding new recipes to cook.

What is your favorite children’s book?
“Where the Sidewalk Ends” by Shel Silverstein.

Do You Have Any Pets?
Not yet- I love dogs!

What do you like to do for fun?
For fun I enjoy spending time with family and friends.

Who is your hero and why?
My Grandma Manuela is my hero because she is the strongest and most giving person I know!

What is the best thing about your job?
The best thing about my job is having the opportunity to connect with so many incredible children and families! They teach me so much and it’s a privilege to join them along their journey.

Keri Schoenemann

MS, CCC-SLP, CAIP

What is one unique fact about you?
I took a semester off and lived in Spain for three months in the middle graduate school.

What is your favorite place to vacation?
Costa Rica

What is your favorite children’s book?
Amelia Bedelia

Do you have any pets?
Nope, just my plants.

What do you like to do for fun?
Something active or adventurous with my husband and spending time with friends.

Who is your hero and why?
My hero is my dad. He lost part of his hand in an accident as a young adult but that has never stopped him from working hard. Growing up I remember noticing that he never made excuses for something being difficult and always modeled working hard when it wasn’t easy.

What is the best thing about your job?
I love when parents get excited about their child’s accomplishments. When they tell me about using new words with a friend or eating a new food for the first time it makes my day!

Brittany Larson

MS, CCC-SLP, CAIP

What is one unique fact about you?
I went skydiving for my 18th birthday and bungee jumping in Australia off a 165 foot bridge.

Where is your favorite place to vacation?
Anywhere that has a beach!

What is your favorite children’s book?
“The Day the Crayons Quit” by Drew Daywalt

Do You Have Any Pets?
I have a mini poodle who is 14 years old named Maxie.

What do you like to do for fun?
I like to spend time with my family and friends, watch movies and travel.

Who is your hero and why?
My heroes are my parents. They have been supportive in anything that I have wanted to accomplish and have been the cheerleaders along the way.

What is the best thing about your job?
I love becoming an extended part of each family that I get to work with. Each patient and family I get to work with holds a special place in my heart and sharing the excitement about their child’s accomplishments brightens my day!

Leah Estep

MS, CCC-SLP, CAIP, ADHD-RSP

What is one unique fact about you?
I conquered my fear of heights when I was 19 years old by bungee jumping from a 170 ft bridge over a river in Canada.

Where is your favorite place to vacation?
The Beach

What is your favorite children’s book?
“The Giving Tree” by Shel Silverstein

Do you have any pets?
Yes, I have a boxer/lab mix named Nora

What do you like to do for fun?
Spend as much time with my family as possible–they make everything fun!

Who is your hero and why?
My mother–not only is she incredibly nurturing and loving, but she is also one of the hardest workers I know. She holds herself and those around her to high standards and she exudes excellence in all that she does. She is open-minded, compassionate, and adventurous.

What is the best thing about your job?
I love the fact that I am able to develop long-term unique relationships with each of my patients and their families. It is an incredible privilege to be able to watch so many kiddos develop and grow up over time. I feel lucky and thankful every single day for my job.

Tamika Magloire

MS, CCC-SLP, IBCLC, CAIP

What is one unique fact about you?
My older brother has a cognitive-communication disorder.

Where is your favorite place to vacation?
Anywhere warm

What is your favorite children’s book?
“There was an Old Lady Who Swallowed a Fly”

Do You Have Any Pets?
Blue Heeler Mix. Her name is Storm 🙂

What do you like to do for fun?
I enjoy being active, playing volleyball, enjoying the outdoors, and spending time with friends.

Who is your hero and why?
My hero is my younger sister. She has overcome so much adversity and continues to strive to be a better individual and overall humanitarian.

What is the best thing about your job?
I enjoy working with such a diverse population and having the flexibility to be as creative as I’d like. I love collaborating with this amazing, outgoing, and energetic team, which matches my personality.

Ciera Gianni

MS, CCC-SLP, IBCLC, CAIP

What is one unique fact about you?
I traveled to Zambia, Africa on a speech therapy mission trip to educate the community about children with communication impairments and disabilities.

Where is your favorite place to vacation?
I love the beach but I also love visiting other countries. I don’t like traveling to the same country more than once.

What is your favorite children’s book?
“Beautiful Oops!” by Barney Saltzberg

Do You Have Any Pets?
Lyla, basset hound

What do you like to do for fun?
I enjoy hanging out with my family, traveling, reading, going to the movies and running.

Who is your hero and why?
My mother is my hero because she taught me that you can accomplish your dreams at any age. She received her doctoral degree in education at the age of 56. She inspires me every day that it is never too late to continue to pursue my dreams.

What is the best thing about your job?
Educating parents and providing them the skills to help make their child succeed in the home environment. I love receiving updates of new skills their child has learned at home.

Jeanine Roddy

MA, CCC-SLP

I believe every child has endless potential and is not defined by their area of need.   Fostering individual change is possible when a therapist is passionate about their calling and given the resources to implement their expertise.  In this way we will positively change the course of life for the children and families we service.

What is one unique fact about you?
I have spent most of my life competing. As a young adult, I earned a scholarship to swim at the University of Kansas and competed at the U.S. Open and National Championships. Upon graduation, I began endurance running and competing in triathlons. Racing at the U.S. Triathlon Championships with my father was one of my fondest memories.

Where is your favorite place to vacation?
Nothing beats the beauty or culture of France. Fabulous food, beautifully manicured parks, incredible beaches, and towering Alps.

What is your favorite children’s book?
“What Do You Do with an Idea?” by Kobi Yamada

Do You Have Any Pets?
I’m a crazy cat lady!

What do you like to do for fun?
On the weekends, you may find me cheering on my son at the baseball fields or applauding for my daughter at the theater. Perhaps if I am lucky, we may be boarding an airplane on our way to a new adventure.

What is the best thing about your job?
Each child presents their own unique strengths and challenges. My favorite part of being a speech pathologist is figuring out how to unlock each child’s potential by utilizing their strengths to alleviate their weakness. Humans have an inherent drive to eat and communicate with one another; being able to foster’s a child ability to enjoy mealtime with family or express their thoughts and feelings is a true joy.