How to check your Out-of-Network Insurance Reimbursement

Refer to the information below for contacting your insurance company to determine how much you will be reimbursed for services with us.

Call the member services phone number on the back of your insurance card.

  • Tell the Customer Service Representative you would like information about your coverage for Speech Therapy benefits with an Out-Of-Network provider.

  • Document your conversation:

    • Name of Customer Service Representative​

    • Date of call

    • Time of call​

 

  • Have the following information ready & available for the call in the event they need it:

    • Insured’s Name:

    • Patient’s name:

    • DOB:

    • Insurance Member ID:

    • Policy/Group Number:

    • Provider: Cynthia Heryanto / Communication Horizons Speech Therapy

    • NPI Numbers: 1801156682 (Cynthia) / 1760143390 (Communication Horizons)

 

  • Ask these questions if relevant, when speaking to the Customer Service Representative:

    • What is my coverage for Speech Therapy benefits?

    • Do I need pre-authorization for Speech Therapy? If so, how do I obtain it?​​

    • Can I submit a Superbill?

    • What is the process for filing a claim after I have a Superbill for services?

    • What additional forms do I need to submit when filing my claim?

    • Where can I find the forms on your website? Can you email me a copy?

    • Can I file my claim online or do I need to mail/fax it to you?

    • Do I need to file my claim within a certain amount of time after the date of service?

    • How long does it take to process my claim?

    • Can I appeal if a claim is denied?