Billing & Insurance
Simply Therapy is in-network with NC Medicaid, NC Health Choice, and the following North Carolina Medicaid Managed Care Organizations, including Healthy Blue, WellCare of NC, and United Healthcare Community Plan of NC.
We are not an in-network provider with any private insurance companies, and we do not bill them directly. However, we can assist you in getting reimbursed for your child’s therapy services if your plan has coverage available for out-of-network providers. Families with private insurance are required to pay at the time of service. At the end of each month, your family will be provided with a billing form that can be submitted to your insurance company, along with your receipts showing payments. All reimbursements from your insurance company will be sent directly to you. We strongly recommend that you call your insurance company BEFORE your first visit to confirm your out-of-network speech therapy benefits. Our office is happy to provide you with procedure and diagnosis codes that you can ask your insurance company specifically about to ensure you get your questions answered correctly and efficiently when you call.
Contact us to learn about our rates and how out-of-network reimbursement may work for you.
Referrals
We accept referrals directly from physicians and other providers. Please review our process below and fax referral forms to (336) 419-2755. We also welcome self-referrals directly from clients or parents. Please call our office at (336) 837-4222 to speak to our staff about scheduling an appointment.
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Providers can fax signed orders for an evaluation to the number above
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Currently, we are in-network with NC Medicaid, NC Health Choice, and all the following North Carolina Medicaid Managed Care Organizations, including Healthy Blue, WellCare of NC, and United Healthcare Community Plan of NC
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When we receive a referral from a provider, we will contact the parent/caregiver of the client to schedule an initial evaluation
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The results of the evaluation will be used to generate a plan of care and treatment goals
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Evaluation reports will be shared with referring physicians and any other approved provider on the child's team
If your child is eligible for NC Medicaid, NC Health Choice, or one of the NC Medicaid Managed Care Health Plans, then a physician referral is required, but we are happy to request it from your primary care provider on your behalf. Otherwise, we do not require a referral in order to schedule your appointment.
Frequently Asked Questions
What forms of payment do you accept?
We accept all forms of payment, including cash, credit cards and checks. We also accept HSA and FSA cards, as speech therapy is considered an eligible medical expense.
How long will my child need therapy?
The length of treatment required will vary based on a variety of factors, including their diagnosis, severity of delay/disorder, attendance, follow-through at home, motivation, compliance, and other medical considerations. Most clients attend therapy sessions 1 to 2 times per week. Your child’s treatment plan will be discussed in detail with you at the first therapy session. While some delays/disorders require only a few weeks or months of treatment, others take much longer.
Do parents attend the sessions?
We always encourage parents to sit in on their child’s therapy session. It is important for the parent to see how hard their child is working in therapy, learn helpful therapeutic techniques from the therapist, and provide feedback regarding the child’s progress outside of the therapy room. We understand that it is not always possible for parents to attend their child’s sessions, but we do ask that the parent make every effort to be as involved as possible in their child’s treatment.
What is the difference between the services you provide and the services my child is getting at school?
Both services are provided by licensed and certified speech-language pathologists, and both services are designed to meet the unique needs of your child. Children receiving services through their public school must meet certain eligibility criteria in order to qualify for services and their delay/disorder must have a negative impact on their educational progress. Services provided at schools are often provided in a group setting and parents usually do not participate in therapy sessions. Private speech therapy (the type we provide) is able to use all aspects of the child’s life, including home, school, and community-based considerations in determining eligibility for services. Parents are encouraged to participate in their child's therapy sessions and are trained on how to carry over new skills into the home environment. Therapy is always provided in a one-on-one session, free from distractions, and designed specifically to meet your child’s individual needs. Services provided through public schools are free and available to any child age 3 and up who qualifies for them. Our services are provided for a fee and may be paid for by medical insurance carriers, NC Medicaid, NC Health Choice, an NC Medicaid Managed Care Health Plan, or by the parent via cash, check, or credit card.
What are your COVID-19 procedures?
Due to the constantly changing recommendations regarding COVID-19, please call our office for the most up-to-date policies for our clinic (336) 837-4222.
Can I leave the office during my child’s therapy session to run a quick errand?
Parents and caregivers are required to remain on office property during their child’s therapy session and may not leave, even for a short errand. Waiting in the car or parking lot is appropriate when the parent is not able to attend the therapy session.
Will I lose my therapy slot if my family is planning an extended vacation?
We will happily hold your child’s previously held therapy slot for 2 weeks for a planned vacation, transition period, or change in medical status. Beyond that, we will offer that spot to a child on our waiting list. You may still return for therapy at any time, but we can not guarantee that your previously held appointment slot will be available.
What is your cancellation and attendance policy?
In order to keep our practice running smoothly and to enable us to serve as many children in our community as we can, we require all clients and their families to abide by our attendance policies. Each time a client misses an appointment without providing proper notice, another client is prevented from receiving care.
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Tardiness: If you are more than 7 minutes late to your appointment, we will be unable to bill for the session and must cancel or reschedule.
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Late Cancels: A 24-hour notice is expected, with the exception of extreme circumstances. We understand that emergencies happen and children come down with illnesses quickly. When an appointment is canceled within 24 hours of the appointment, but BEFORE the appointment has started, we consider that a “late cancel.”
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No Shows: Appointments that are not canceled with a 24-hour notice or that don’t meet “late cancel” criteria are considered a “no show.”
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Illness: If your child has recently been sick, please ensure they are fever-free AND symptom-free for at least 24 hours before coming to therapy.
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The Importance of Regular Attendance • In order to remain on our weekly schedule, we ask that your child attend at least 75% of their appointments over an 8-week period. Attendance that slips below 75% is creating a significant disruption in your child’s treatment plan. If your child is unable to maintain this percentage, they will be removed from our weekly schedule. We understand that life gets complicated and priorities change. If your family is going through a transition time, planning for extended vacation, or if your child is experiencing a health condition or needs a medical procedure that requires frequent or extended absences, we are happy to pause services until your family is able to commit to regular attendance once again. We are also happy to adjust your appointment time and day, if needed, to better suit your schedule.
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If you need to cancel your session, please call your therapist directly, or call our office a (336) 837-4222.
You can download our complete attendance policy here.