Insurance and Payment
How are Services Paid For?
Access to care is our top priority, and we are here to help.
Navigating insurance coverage for occupational, physical, or speech therapy services can be confusing, and is too-often full of surprises. We will help you understand your benefits with your specific plan as much as possible prior to accumulating charges. Please note that in general, deductibles, co-pays, and visit limits will apply to our therapy services. If you do not have secondary insurance, co-pays are collected at the time of service via check or credit/debit (including HSA/FSA cards).
It is against regulations for us to accept cash/private pay from clients with Medicaid coverage for services that are covered under your Medicaid plan. These regulations are designed for YOUR protection, to prevent you from paying out of pocket for services that you are entitled to. For this reason, in order to receive services at our office we must be in-network with your Medicaid plan. This applies to primary and secondary Medicaid coverage.
Currently, we are in-network with:
Blue Cross/Blue Shield
Capital Blue Cross
Geisinger Health Plan
Highmark Blue Shield (NOT Highmark Wholecare Medicaid)
Medicaid: Amerihealth Caritas PA, Geisinger Family Plan, and UPMC For You
We do not accept Highmark Wholecare Medicaid plans
We are able to accept CHIP plans with Highmark, Capital Blue, Aetna Better Health, and UPMC.
Finances should not get in the way of your child’s health, and as a nonprofit organization, we are here to help as much as possible. If we are not in-network with your insurer, we are happy to help you navigate any out-of-network benefits you may have. Alternatively, we are able to accept payment via cash, check, or credit/debit, including HRA/HSA funds. Per the No Surprises Act effective 1/1/2022, if you are uninsured or self-pay, you have the right to receive a Good Faith Estimate for the total expected cost of care. We will provide this to you at least one business day prior to your first appointment. Please contact us with any questions about insurance and/or our pricing. For details on the No Surprises Act and Good Faith Estimates, visit www.cms.gov/nosurprises.
Please note that all Community Group Programs are paid for privately, as they are NOT individual therapy services and are therefore not eligible for insurance coverage. They are also NOT able to be submitted to insurance for out-of-network reimbursement.