It is imperative that we have current information prior to the first session. Some insurance companies require pre-authorizations and without one, session fees are parents responsibility. Please email or fax a copy of the front and back of your insurance card in addition to filling out this section.

Rates (as of 1/2/23)

Evaluation: $ 500.00 (includes written report)

Individual session: $ 125.00

60 minute meeting/consult: $ 175.00

Additional note(s) $ 100 (non-payable by insurance) 

Home Programming $ 175.00/hr

Payment

For clients with insurance that Wee Speech, P.C is “in network”, insurance will be billed electronically. Wee Speech, P.C. will collect payment (co-pay, co-insurance, deductible fees) from responsible party by billing the credit card on file after insurance payment or estimation of benefits is received by Wee Speech, P.C. It is the family’s obligation to review and or contact their health plan to determine if speech therapy services are covered as well as if a pre-authorization or any other authorization is needed. Families are responsible for charges incurred that are not covered by their plan.

For clients with insurance that Wee Speech, P.C. is NOT “in network” with, family will be billed at the above rates. Wee Speech, P.C. will collect from responsible party/family by billing the credit card on file after each session has been completed. It is the family’s obligation to review and/or contact their health plan to determine if speech therapy is covered as well as if preauthorization or any other authorization is needed. Families are responsible for charges incurred that are not covered by their plan.

For clients without insurance/who chose not to use insurance for speech therapy/have insurance that does NOT cover speech therapy benefits, families will be billed for services rendered at the above rates.

The family is responsible for all unpaid bills.

If an outstanding bill remains unpaid for 45 days, regardless of the insurance status, you will be charged a monthly finance fee in the amount of 1.5% of the outstanding balance or $ 50, whichever is greater.

Cancellations

It is understood that a family may have to occasionally cancel treatment sessions, however, 24 hour notice is required. Please cancel your child’s therapy appointment if she/he has any symptoms of illness including fever within the past 24 hours. To  maintain continuity of care, we encourage rescheduling the session and or changing the platform to teletherapy. Frequent cancellations in a three-month period may result in a loss of your reserved time slot and a move to floating status. Clients on floating status will be offered openings as they arise. Any appointments not cancelled given 24 hour notice (barring medical emergencies) will result in a $ 50.00 fee to the family.

 

Attendance

I understand that consistent attendance plays an important role in maintaining my child’s progress in therapy and preventing regression of skills. As such, I agree to make my best effort to attend the scheduled sessions on a regular basis. I understand that sessions are scheduled for each client on the same day and time slot each week. I will only accept a time slot if I am able to attend that day/time on a weekly basis.  

Therapy sessions 

If your child attends his/her session with another caregiver (e.g. grandparent, nanny) the clinician will update them regarding your child’s session only if there is a release of information signed. You may pay a fee of $25 for up to a 20-minute phone conversation with your child’s clinician during office hours to discuss your child’s progress. The fee cannot be billed to insurance.

Office Etiquette

Please plan to be in the waiting room to pick up your child at least 5 minutes prior to the end of his/her therapy session. Clinicians will not walk your child outside of the clinic. There will be a $ 25 fee for every 15 minutes you are late to pick up your child. This fee cannot be billed to your insurance company.

         Notice of Privacy Practices

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. This notice gives you information required by law about the duties and privacy practices of Wee Speech, P.C. Reasons for which we may use or disclose your personal health information without your authorization: To provide eligibility information to your doctor or to recover costs from medical insurance. To comply with legal proceedings. Uses and disclosures with your permission: We will not use or disclose your personal health information for any other purposes unless you give your written authorization to do so. You may request copies of your health information with written authorization.

Complaints

If you believe your privacy rights have been violated by Wee Speech, P.C. you have the right to complain to us or to the Secretary of the U.S. Department of Health and Human Services. We will not retaliate against you if you file a complaint.

HEALTH INFORMATION INCLUDES AND RELATES TO:

1) Your child’s past, present and future physical, medical or mental health conditions.

2) Your past, present, or future payment for the care of services your child received.

3) Care and services provided to your child.

REVISIONS/CHANGES TO PRIVACY NOTICE

Wee Speech, P.C. is required to follow the terms of this notice until the notice is revised. Wee Speech, P.C. reserves the right to change the contents of this notice at any time.

8707 Skokie Blvd. Ste 402  Skokie, IL 60077  (847) 329-8226 www.weespeech.com