Friday, March 22, 2019

Navigating the World of Insurance

A common story: You take your child to the doctor and the doctor recommends speech or you ask for a referral.  You set up an appointment, see the speech therapist and later find out speech therapy is not covered! It might not make sense, the doctor recommended it and your child has a speech and/or language disorder! Unfortunately this can be an all too common story.

As a policy holder, it is your responsibility to know your insurance plan. But this can be challenging with the many terms that they use throughout the policy.  Lets explore some of the common terms that might be used when describing coverage with speech.

Habilitative/Rehabilitative: These terms can be two very important terms when it comes to treatment coverage.  Habilitative care is a type of treatment that is for helping a client obtain or improve a skill they did not develop on their own.  For example, a child who cannot say their "r" would be considered habilitative.  The child did not develop this skill and needs to be gained though treatment. Rehabilitative care is a type of treatment for helping clients regain a skill or function that was lost due to illness or injury.  For example, a child who suffers a head injury and is having difficulty expressing thoughts or ideas.  It is not uncommon for insurance companies to not cover habilitative services and this would be important to understand with your insurance policy.

Exclusions: This indicates diagnosis or procedures that are excluded from coverage.  Some insurance policy's state that developmentally based diagnosis are excluded from coverage.  Some insurance coverage's reasoning behind this can be due to the fact that these types of services are provided through the local school district.

Preauthorization/precertifications: This refers to the need for the insurance company to indicate that the evaluation or treatment is medically necessary.  It should be noted, even if prior authorization was given, this does not guarantee the insurance company with cover the costs.

Co-insurance/Copay/Deductible: These terms refer to policy holder's responsibility for costs. Deductible is the fixed amount you are responsible for before your policy begins paying.  However, after your deductible is met you might have co-insurance or a copay.  Co-insurance refers to the policy holder being responsible for a percentage of the costs billed.  For example, if the bill is for $100 and you have a 10% co-insurance, you would be responsible for $10.  Copay's refer to a fixed rate paid for health care services.  These can change based on the service being used.

In network/out of network: These terms refer to the service provider providing the care.  In network providers have a contracted rate with this insurance company and are preferred providers.  Out of network providers do not have a contracted rate.  Many insurance policy's have different deductibles and cost sharing responsibilities for the policy holder if using out of network providers.

Navigating the insurance world can be overwhelming.  It is important to find a provider who is willing to help understand your coverage and provide you with resources as needed.  At Building Blocks Therapy Services, it is important for us to spend time to help the clients understand their coverage as much as possible from the start.



If you find yourself wondering more about speech and language services contact Building Blocks Therapy Services at (616) 666-6396 or visit www.buildingblocksgr.com

Courtney Joesel MA CCC-SLP is the owner and clinician at Building Blocks Therapy Services in Grand Rapids, MI.  

Images courtesy of canva.com





Monday, January 28, 2019

5 Ways to Support Your Child's Language Development




Every parent wants to provide the best opportunities for their child to reach their highest potential.  Children typically say their first word around 12 months of age and rapidly increase their vocabulary and use there after.  Let's chat about 5 ways to support the development of their language before and after 12 months of age

1. Narrate your day

  • The more the words the child hears in their early life the better.  Narrating your day provides multiple opportunities for the child to be exposed to a variety of vocabulary words.  Examples might be "I put the ducky in the water" while giving a bath or " I want yellow bananas" while at the grocery store.  Great times to narrate are while cooking, driving in the car, grocery shopping, dressing the child, sorting the laundry 


2. Create Routines

  • Creating routines provides consistent language and predictability throughout their day. Routines gives a great way to teach the child new words and phrases.  Establish routines with consistent actions and words into smaller steps.  As the child learns the routine, wait to see if they complete the next step with an expectant pause.  


3. Use more statements than questions

  • It can be so easy to find yourself asking many questions to your child, " What is that?", "What are you doing?", "What did Elmo say?".  By changing these into statement "That is a cow.", "You are jumping high." or "Elmo said GO!" This encourages vocabulary development and the use of language.  The child will also be more likely to repeat what you said 


4. Don't give them everything they need at once

  • A great example of this would be playing with a puzzle.  Provide one puzzle piece at a time or have them ask for each puzzle piece.  This can provide the opportunity to learn new vocabulary or practice using the vocabulary.  During meal times, having the child request for "more" is a great introductory skill


5.  Give choices

  • Providing the child with choices inherently implies they are to respond.  At the same time, this is a great time for vocabulary development and practice for using the vocabulary by providing them with the name of the items.  A great example of this would be with food, "Do you want the apple or cracker?" while showing the items as you name them.  


If you find yourself wondering more about these strategies and curious of other ways to support your child's language development feel free to contact Building Blocks Therapy Services at (616) 666-6396 or visit www.buildingblocksgr.com

Courtney Joesel MA CCC-SLP is the owner and clinician at Building Blocks Therapy Services in Grand Rapids, MI.  



Navigating the World of Insurance

A common story: You take your child to the doctor and the doctor recommends speech or you ask for a referral.  You set up an appointment, ...