Insurance & Medicaid Information

The Therapy Village accepts all types of insurance as form of payment, but we are “in-network” with the following companies:

Insurance

  • Aetna
  • Blue Cross / Blue Shield
  • Cigna
  • Humana
  • PHCS (Only ST/OT)
  • United Healthcare

Medicaid

  • TCHP CHIP
  • TCHP Texas Star Program
  • TMHP (Traditional)

In the case that we are not “in network” with your insurance, we will still submit claims to your insurance on your behalf however your benefits will be “out of network”. This means you are subject to a higher deductible and are responsible for a greater percentage of the total therapy charges.

Benefits for Therapy

Your insurance benefits for therapy services will be checked and reviewed with you in detail before your first visit to the clinic. However please note that benefits which are quoted to you are not a guarantee of payment. Benefits are payable specifically to your insurance plan, so NEVER assume your QUOTE of benefits will ensure payment for the services rendered.

Many health insurance plans do provide benefits for Speech, Occupational and Physical therapy; however, there are limitations and exclusions for coverage based on your individual plan. Limitations may be related to a child’s age, diagnosis, for the number of therapy sessions a child may receive per year, etc…

We will submit claims to your insurance company on your behalf and upon receiving any denial(s) for therapy, we will notify you immediately and discuss a plan of action regarding your child’s services. We will appeal, submit documentation, and make every possible to attempt to get services rendered paid by your insurance but you are ultimately responsible for any charges that are denied.

Helpful Tips

When speaking with the insurance company, it is imperative that you take written notes, including the name of the representative, time, date, and reference number for the call. This information will be helpful to us with our appeal, in the case of a denial.

Read over your insurance company’s Explanation Of Benefits (EOBs) when you receive it in the mail. This will provide you with detailed information regarding what charges your insurance company paid, what your co-payment/co-insurance was for that session, how much of their payment and yours went towards the deductible.

Please note: a member receives EOBs before the provider. If you have any questions regarding your EOBs, we will do our best to help you and will contact the insurance company on your behalf for any additional concerns.

You are ultimately responsible for any services not paid by your insurance company.