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Archive | Health Insurance 101

Communication Difficulties

The inability to use speech to communicate may be very limiting!  A person without a voice may find themselves unable to express their choices, interact socially, or obtain their basic needs and wants.  They may feel closed off from the world in many ways.  Most of us usually utilize speech, facial expressions, gestures, eye contact, writing, and typing when we are trying to communicate.

 

Since we are a speech-language clinic- we embrace communication however it manifests, in addition to a formal means of aided communication (e.g. use the sign for “bathroom”, “eat” and “drink”, tap on a person’s shoulder to get their attention, etc). You see communication itself is a fundamental characteristic of humanity.

By on August 18, 2017 in Autism Treatment, Cognitive Therapies, Feeding & Swallowing Therapies, General, Health Insurance 101, Hearing Impairment, Philanthropy, Resources, Speech Therapy, Uncategorized, Videos, Voice Disorders, What to Expect, Who We Are

Aprax…huh??

If someone is suffering from Apraxia, they already know what words they want to say, but at times their brains may have difficulty coordinating the muscle movements necessary to say all the sounds in the words they want to use.

As a result, they may say something completely different or make up words (e.g., “micken” or “chicken” for “kitchen”).

The person may recognize the error and try to attempt to say the word again—sometimes they may even get the word right, but sometimes saying something else entirely. This situation may become quite frustrating for the person, to say the least.

Individuals with apraxia may show these signs or symptoms:

-difficulty imitating and producing speech sounds, marked by speech errors such as sound distortions, substitutions, and/or omissions
-inconsistent speech errors
-groping of the tongue and lips to make specific sounds and words
-slow speech rate
-impaired rhythm and prosody (intonation) of speech
-better automatic speech (e.g., greetings) than purposeful speech
-inability to produce any sound at all in severe cases

By on August 17, 2017 in Autism Treatment, Cognitive Therapies, Feeding & Swallowing Therapies, General, Health Insurance 101, Hearing Impairment, Philanthropy, Resources, Speech Therapy, Uncategorized, Videos, Voice Disorders, What to Expect, Who We Are

Supply and Demand

We get it, we really do… On your end of the receiver, you hear a busy signal or a voicemail greeting asking you to leave a message. On our end of the receiver, we are fielding phone calls from insurance companies, doctors offices, hospitals, patients, state agencies and more. Each day we are handling more and more phone calls involving everything from new regulatory demands to updated prescription information, as well as concerns from sick patients, and billing issues—and lately, as our practice grows (specifically the increase in our clinical staff) we are hearing from more and more patients regarding our appointment availability.

Supply and Demand… There are only some many of us available at any one time to answer the telephones as well as interact in person with each of our patients or caregivers. We are not complaining… We love the additional work and the additional responsibilities, it tells us that we are clearly doing something right. What we are doing is asking for a little bit of patience. If you do get a voicemail greeting asking you to leave a message or our receptionist tells you that all staff is currently busy could you please hold, or if you could please leave us a message, please do just that. We pride ourselves in returning all messages within 24 hours. If you ask us to call you back, we will… That’s a promise..

By on August 16, 2017 in Autism Treatment, Cognitive Therapies, Feeding & Swallowing Therapies, General, Health Insurance 101, Hearing Impairment, Philanthropy, Resources, Speech Therapy, Uncategorized, Videos, Voice Disorders, What to Expect, Who We Are

Back-to-School Tips from Miss Rachel!

Welcome back to another school year!  Welcome back to waking up early, following a morning routine, fitting in homework, sports, chores and everything else life brings!

For many kids, managing time and following a routine is nearly impossible.  Their brains are still developing this higher level thinking skill (Executive Function).  In order to help them be successful, sometimes we need to change the environment.  Changing simple things around the house can create great changes in children.  Throughout the year we will provide some tips for helping with time management and organization at home and school.

For now, start with compassion!

Let your child know you understand how painful it must be to struggle with getting things done.  It is not his/her fault they may struggle with time management, it involves the wiring in the brain.  Let them know you will work together on strategies to help him/her and…THE WHOLE FAMILY!   Mentioning that the whole family will be working together on this may help take some of the stress from your child.

Keep in mind: You can’t do what you can’t do.  Your child isn’t an adult yet.  Be patient.  We’re all in this together!

Adapted from “50 Tips to Help Students Succeed” by Marydee Sklar
#NotYourAverageClinic #NotYourAverageClinicians

By on August 15, 2017 in Autism Treatment, Cognitive Therapies, Feeding & Swallowing Therapies, General, Health Insurance 101, Hearing Impairment, Philanthropy, Resources, Speech Therapy, Uncategorized, Videos, Voice Disorders, What to Expect, Who We Are

Health Insurance 101: Premiums and Co-Pays

Most people are confused by their health insurance, they are unsure of what it covers and how much they will have to pay in any given situation.  That’s easy to understand, health insurance policies are written in such a way that the average person just doesn’t carry those terms around in their heads every day.  However, understanding your health insurance policy is key to receiving the care your premiums pay for you to receive.  There are many different aspects to health insurance policies, and I wouldn’t presume to be able to address them all here, but I will attempt to address the most common and quite often, the most important.   Premiums, co-pays, coinsurance, exclusions, deductibles, In network and out of network, stop loss, out of pocket, and preauthorization’s, are all terms we have each heard at one time or another, but what do they mean?

Premiums are quite simply the contribution you must make each month, or quarter, or year to keep your insurance coverage active.  If you fail to make your premium payment, your health insurance policy may be canceled and you may be left with no coverage at all.  It is very important that your premiums are always paid when they are due.  Quite often, if you receive your health insurance benefits from a group policy offered by your employer, your premiums are deducted from your paycheck and always paid without any effort on your part.

Co-pays are not health insurance premiums, they are your portion or share of cost for the current visit, procedure, event, or appointment you are participating.  Co-pays are always the responsibility of the patient or patients responsible party and cannot be waived, reduced, or discounted.   Sometimes a patient will ask whether or not a co-pay can be reduced, waived or forgiven, and the answer is always no.  Many people don’t realize this, but there are actually federal laws that prevent providers from doing this, so quite simply…  It’s against the law, please don’t ask…

My experience has shown me that premiums and co-pays are the easiest terms for most people to understand when discussing their health insurance, but coinsurance is where it starts to get murky.  Coinsurance is the amount that is left over after the claim has been submitted, approved and paid.  The coinsurance is always the responsibility of the patient or the patients responsible party.   To give you an example: say you visit an “in network provider” for ACME Insurance.  You pay your co-pay when you sign in for the appointment, you see the provider, and you leave.  The medical billing staff takes that charge and submits it to ACME insurance for payment.  ACME insurance confirms the claim is valid and pays the claim according to the contract signed by the provider and ACME insurance, minus the coinsurance amount.  To further define this let me add some numbers: the provider submits a charge for 100.00, but the contract between the provider and ACME says they will only pay 95.00, the provider agrees to write off the other 5.00, and accepts 95.00 as payment in full.  However, your insurance policy with ACME says that the will pay 90% of the agreed upon charge and you must pay the rest.  so in this example ACME will issue a check for 85.50 (90% of 95.00) and your coinsurance amount is 9.50 (10% of 95.00)

I hope that helps de-mystify, a few of the commonly used terms when dealing with health insurance.  My next article will continue to define more terms to aid you in understanding more about your health  insurance policy or at least give you some knowledge when speaking with your health insurance company.  “Knowledge is Power.”

By on September 19, 2011 in Health Insurance 101