FAQs

Do you accept Insurance?

1

Elizabeth is an approved provider for Tricare and Medicare for the state of Maryland. For patients who we are out of network for we will provide superbills for you to submit to your insurance provider for reimbursement. We encourage you to check with your insurance company for more details. Please look at our Financial Resources section listed below for more information about insurance reimbursement and network gap coverage that you may find helpful.

Can you Work with my child if they are in speech therapy at school?

2

Yes! Private speech therapy can be an excellent supplement to school services.

3

Does my child have to have speech therapy at school to qualify? What if they weren’t approved for it at school?

What qualifies as necessary for the education environment and what is necessary in the medical environment are so different. At school they are focused in on how speech will impact your child’s education, where we are looking at your child as a whole. We are concerned about how your child is communicating, breathing, eating and how those things impact all aspects of their life now and will go on to do so well beyond childhood.

What is the difference between a recommendation and a referral?

4

A recommendation is the suggestion to you to see a specialist, while the referral is the written or electronic communication from one doctor to another doctor or specialist.

Do you offer telehealth?

5

Yes, if you live in the State of Maryland we can provide Telehealth appointments.

What if I’m not sure if my child needs services?

6

We offer a free 15 minute phone or video consultation to discuss your concerns. From there we decide together if a formal evaluation is what is best for you an your child.

Financial Resources

Insurance Reimbursements

  • A superbill is a detailed invoice provided by healthcare providers that outlines the services rendered during a visit, along with associated billing codes. It includes information such as the provider's name and credentials, patient demographics, date of service, diagnosis codes, procedure codes, and the cost of each service.

  • 1. Obtain a Superbill:

    Request a superbill from your provider following each appointment or service. Ensure that the superbill is completed accurately and includes all relevant information, such as diagnosis and procedure codes.

    2. Review Your Insurance Policy:

    Familiarize yourself with your insurance policy to understand your coverage, deductible, copayment, coinsurance, and any out-of-network benefits. This information will help you determine your eligibility for reimbursement and the amount you can expect to receive.

    3. Verify Out of Network Benefits:

    Some plans may offer out-of-network benefits, reimbursement rates may vary, so it's essential to confirm your coverage before seeking reimbursement.

    4. Submit the Superbill:

    Submit the completed superbill along with any additional required documentation, such as receipts or explanation of benefits (EOB), to your insurance company. You can typically submit the superbill online through your insurance provider's website or via mail.

    5. Monitor the Reimbursement Process:

    Keep track of your reimbursement claim by monitoring the status online or contacting your insurance company directly. Be prepared to follow up if necessary and provide any additional information requested by the insurance company.

    6. Understand Reimbursement Policies:

    Familiarize yourself with your insurance company's reimbursement policies, including deadlines for submission, documentation requirements, and appeals process. This knowledge will help you navigate any potential challenges or discrepancies in the reimbursement process.

    • Keep organized records of all healthcare expenses, including superbill copies, receipts, and EOBs.

    • Take advantage of flexible spending accounts (FSAs) or health savings accounts (HSAs) to cover eligible out-of-pocket costs.

    • Advocate for yourself by communicating with your healthcare provider and insurance company to ensure accurate billing and timely reimbursement

  • We can submit your Superbill directly through Reimbursify.

Network Gap Exceptions

  • A network gap exception is a request you can make to your insurance company to have services from an out-of-network provider, like Anchor, Nourish & Flourish, covered at the in-network rate. This can be a valuable tool when there’s a lack of in-network providers who meet your child’s specific needs or are available within a reasonable timeframe.

  • If your insurance company approves your request for a network gap exception, you’ll essentially be treated as an in-network patient for billing purposes, even though you’re seeing an out-of-network provider. This means you’ll receive a higher reimbursement rate for your speech therapy sessions, lowering your overall expenses.

    • Insurance companies typically consider these exceptions in situations where:

      • Limited In-Network Options: There are no in-network speech and feeding therapists with appropriate expertise or availability near your location.

      • Long Waitlists: In-network providers have extensive wait times, potentially delaying crucial intervention for your child.

      • Specialized Needs: Your child requires a specific type of speech therapy not offered by in-network providers.

    1. Contact Your Insurance Company: Start by calling your insurance provider to understand their specific requirements and process for gap exception requests.

    2. Gather Supporting Documentation: This may include a letter of medical necessity from your child’s doctor, evidence of your search for in-network providers, and information about the qualifications of Anchor, Nourish & Flourish

    3. Submit Your Request: Follow your insurance company’s guidelines for submitting the request and all necessary documentation.

    4. Follow Up: After submitting, periodically check on the status of your request with your insurance company.

  • We will provide necessary documentation for your insurance provider, and assist you as we can. For your information on gap exceptions click here.

Other Financial Resources

  • This grant is open to Maryland Families who have a child or family member at home who is disabled and not receiving support from the DDA. Find the application and more information here.