Insurance
Speech Stars, PLLC is an in-network provider for Blue Cross Blue Shield of NC, MedCost, Aetna, Aetna/State Health Plan, United Healthcare and Medicaid (Medicaid direct, Vaya, Alliance); including the following managed care plans - AmeriHealth Caritas, Carolina Complete Health, Healthy Blue, United HealthCare Community Plan, and WellCare.
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If you have insurance concerns, please contact your insurance provider or our office for more information.
Common Insurance Terminology:
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Allowed Charges-Amount an insurance company will reimburse an in-network provider for services rendered to their client.
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Authorization-Approval from insurance provider for a covered service to be eligible for payment. Often takes 5-7 business days and allows for a maximum number of sessions within a certain time-period.
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Co-insurance-The client may be required to pay a certain % of the allowed charges as required by his/her contract with the insurance provider. For example, an insurance provider may 90% and the client may be required to pay 10% of the allowable charges.
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Co-pay-The dollar amount a client is required to pay for each date of service.
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Explanation of Benefits (EOB)-A description of claims processed by the insurance provider. EOBs typically include the following information: type of service, date(s) of service, billed charges, payments, reasons for denial, and patient responsibility. It is very important that you read your EOBs as we do not track benefit caps on therapy services.