Helpful Information

Insurance Coverage

MarvelMyo & Speech is currently in-network with Medicare and Blue Cross Blue Shield.

Blue Cross Blue Shield includes the following:

  • BlueChoice PPO

  • Blue Essentials

  • HealthSelect of Texas

  • Blue High Performance Network

  • Blue Advantage HMO

  • Blue Premier

  • Blue Cross Medicare Advantage PPO

  • Blue Cross Medicare Advantage HMO

We are considered an out-of-network provider for all other insurances.

We provide a Superbill (receipt) with our coding for all out-of-network patients that can be submitted for possible reimbursement.

We advise that patients call their insurance about out-of-network benefits for speech therapy prior to scheduling an evaluation.

Payment and Benefits of Working with an Out-Of-Network Provider

  • Insurance authorization is not needed to start receiving speech therapy services. After an evaluation is completed, if we feel that the individual would benefit from speech therapy services, we are able to begin speech therapy services immediately without waiting on insurance approval.

  • Often times, insurance companies require a certain standard score or deficit to qualify for services. Working with an out-of-network/private pay therapist means that the individual does not have to score within a certain range to qualify for speech and language services. It also means that we have complete flexibility to tailor the individual’s treatment plan to target goals that are important to you, without worrying about any insurance restrictions.

  • A formal evaluation is not required. We understand that for some individuals, a formal evaluation is not feasible, or not the most realistic way to assess their current skill level. There are many comprehensive informal measures that can be used to assess the individual’s strengths and areas of need to help determine a treatment plan that is appropriate for them. We can provide a treatment plan that is fully customized to the individual’s specific needs.

  • You are not limited to a set number of visits per year or a set duration for treatment sessions. Often times, insurance only approves an allotted amount of sessions per year. By using an out-of-network provider, we are able to work together as a team to determine the number of sessions per week that works best for the individual and their family.

Payment Policies & Insurance Reimbursement | Evaluation Appointment Fees

All payment is due at the time of service. MarvelMyo & Speech accepts payment via cash, credit card, or HSA/FSA cards. A superbill (receipt) can be provided, at your request, if you would like to seek out reimbursement from your insurance. We are happy to speak with you to help you understand what specific questions to ask your insurance provider. It is each family‘s responsibility to confirm eligibility for speech services with their insurance provider prior to starting therapy. We are able to verify Medicare and Blue Cross Blue Shield benefits beforehand, however each family is responsible for any charges that insurance does not cover.

In order to provide the highest quality of care, we hold between 1 to 2 hours for each initial evaluation. Because of the lengthy amount of time that we hold on a therapist’s schedule, we require a $50 non-refundable payment to set the evaluation appointment. This payment goes towards your Myo Kit (tools we need for therapy) and the 30 minute consult to go over your treatment goals. If you reschedule with less than 48 hours notice of the evaluation appointment, a second payment of $50 will be required to hold a second evaluation slot.

Please contact us to inquire about our current rates for therapy.

FAQs

  • MarvelMyo & Speech offers services via teletherapy all throughout the United States

  • How often a client comes to therapy depends on what type of challenges he or she is experiencing, as well as the severity of those challenges. Typically, clients come once or twice a week for individual 30-45 minute sessions.

  • MarvelMyo & Speech therapists work with patients of all ages from birth and up to adulthood

  • We don’t know for sure what causes speech, language, literacy and myofunctional problems. It could be as simple as having a lot of ear infections when young or the speech/language problems could be a symptom of a larger problem. Sometimes myofunctional challenges can be caused by tongue resting posture or compromised airway (sinus issues, etc.) Regardless, it is NOT your fault.

  • If your child doesn’t talk as much as children his/her own age, the problem may be a speech-language delay. Your doctor or teacher may be concerned about a speech-language delay if your child does NOT do the following: Say simple words clearly or unclearly at 12-15 months, understand words like “no” or “stop” by 18 months of age, talk in short sentences by 3 years of age, or tell a simple story at 4-5 years of age. If a late elementary school (or older) child has a persistent /s/ or /r/ error (especially after intervention), then it could suggest that there is some myofunctional challenge as well.

  • There are several areas that a speech-language pathologist will explore/evaluate:

    Speech mechanism. The mouth, tongue, nose, breathing and how they are co-ordinated and operated by muscles. This includes myofunctional assessment when necessary.

    Phonology. The sounds that make up language.

    Syntax and grammar. The way that words and parts of words combine in phrases or sentences.

    Semantics. The meaning of sentences words and bits of words.

    Pragmatics. How language is used in different situations and how feelings are conveyed.

    Intonation and stress. The rhythm and music of the way we speak.

    Literacy. Skills related to reading, including phonological awareness, sound awareness, decoding, encoding and writing.

    Orofacial Myofunctional Disorders: Tongue tie, lip tie, cheek tie, thumb sucking, tongue thrust, open bites, mouth breathing, snoring, sleep disordered breathing, lack of muscle strength of the face, poor swallow pattern, crowded teeth, TMJ issues, headaches and migraines, clenching and grinding, and more!

  • Yes, some insurance plans will cover therapy. We are in-network with Medicare and Blue Cross Blue Shield (BCBS). If your insurance is out-of-network, we will provide you with a “superbill” billing statement with applicable procedure and diagnosis codes for you to submit to your insurance plan for reimbursement. Every insurance plan is different, and some plans may reimburse a certain number of visits. You may be able to see us as an out-of-network provider. Please check with your specific plan to obtain additional information about reimbursement.

  • We require payment at the time of service. All accounts have a credit card saved to the billing software and charges for sessions will be applied after a session has been provided.

  • We currently accept credit cards/HSA/FSA and insurance payments if we are in-network. We are currently in-network with BCBS and Medicare. We can provide Superbills for out of network claims.