Guide for Filing for Out-of-Network Benefits
This guide will assist you as you contact your insurance company to determine their process for filing out-of-network benefits. It should also help you determine if speech therapy benefits are included in your policy as well as how to submit a claim for potential reimbursement for the services you have already paid for.
1. Call the member services phone number on the back of your insurance card.
2. 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
3. Have the following information ready & available in the event they need it:
Insured’s Name:
Patient’s Name:
Date of Birth:
Insurance Member ID:
Policy/Group Number:
Provider: Megan Ledford, MS CCC-SLP, CDP/Deeper Roots Speech Therapy, LLC
State License: #SLP011861
ASHA Certification: #14301674
NPI Number: #1992313530 (Type 1)/#1760139562 (Type 2)
4. Ask these questions 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?